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General NPI Number Information
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NPI Number | 1689938029
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Entity Type | Organization
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Legal Business Name | SAGE INSTITUTE,PLLC
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 905 HALSTEAD BLVD STE 1
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-6815
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Country | US
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Telephone | 910-528-5751
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Fax |
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Provider Business Mailing Address
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Address Line | 1851 W EHRINGHAUS ST STE 180
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4555
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Country | US
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Telephone | 910-585-3407
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHELSEA E GREENE
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Credential | L.P.C.
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Telephone | 910-585-3407
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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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