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General NPI Number Information
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NPI Number | 1386506384
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Entity Type | Organization
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Legal Business Name | SAGE PATH COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 11/27/2025
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 745 BORDENTOWN AVE
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-1472
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Country | US
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Telephone | 732-309-2609
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Fax |
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Provider Business Mailing Address
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Address Line | 745 BORDENTOWN AVE
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-1472
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Country | US
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Telephone | 732-309-2609
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Fax |
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Authorized Official
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Title or Position | OWNER, MENTAL HEALTH THERAPIST
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Name | MS. MELODY SMITH
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Credential | LPC, NCC
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Telephone | 732-305-2609
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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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