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General NPI Number Information
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NPI Number | 1003580010
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Entity Type | Organization
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Legal Business Name | SAGE STONE COUNSELING LTD
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 50 N BROCKWAY ST STE 3-1
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City | PALATINE
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State | IL
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Zip | 60067-5068
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Country | US
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Telephone | 312-351-4225
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Fax | 312-244-3060
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Provider Business Mailing Address
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Address Line | 50 N BROCKWAY ST STE 3-1
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City | PALATINE
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State | IL
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Zip | 60067-5068
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Country | US
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Telephone | 312-351-4225
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Fax | 312-244-3060
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | LAUREN BRANCATO
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Credential | LCPC
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Telephone | 312-351-4225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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