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General NPI Number Information
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NPI Number | 1891224291
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Entity Type | Individual
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Provider Name | STACY GAGE LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 111 SOFTWIND CIR
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City | BALDWINSVILLE
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State | NY
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Zip | 13027-3374
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Country | US
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Telephone | 315-303-2076
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Fax |
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Provider Business Mailing Address
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Address Line | 111 SOFTWIND CIR
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City | BALDWINSVILLE
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State | NY
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Zip | 13027-3374
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Country | US
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Telephone | 585-831-0028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CW026672
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 095959
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20308
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License Number State | FL
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