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General NPI Number Information
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NPI Number | 1023673035
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Entity Type | Organization
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Legal Business Name | SAGE PSYCHOTHERAPY
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 913 SW HIGGINS AVE STE 202
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City | MISSOULA
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State | MT
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Zip | 59803-1423
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Country | US
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Telephone | 406-471-8869
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16952
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City | MISSOULA
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State | MT
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Zip | 59808-6952
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Country | US
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Telephone | 406-471-8869
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. PAISLEY L. MILES
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Credential | LCSW
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Telephone | 406-207-2680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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