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General NPI Number Information
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NPI Number | 1629567441
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Entity Type | Organization
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Legal Business Name | SAGE COUNSELING, INC.
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1849 AIRFIELD AVE
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City | KINGMAN
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State | AZ
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Zip | 86401-4004
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Country | US
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Telephone | 480-649-3352
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 S ALMA SCHOOL RD STE 104
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City | MESA
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State | AZ
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Zip | 85210-3086
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Country | US
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Telephone | 480-649-3352
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | BRANDY JUDSON
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Credential | LMSW
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Telephone | 503-516-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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