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General NPI Number Information
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NPI Number | 1982316477
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Entity Type | Organization
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Legal Business Name | SAGELY LIFE, PLLC
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Dates
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Enumeration Date | 12/16/2022
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 8105 RASOR BLVD SUITE 270
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City | PLANO
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State | TX
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Zip | 75024
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Country | US
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Telephone | 469-626-8116
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Fax |
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Provider Business Mailing Address
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Address Line | 6333 E MOCKINGBIRD LN STE 147
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City | DALLAS
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State | TX
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Zip | 75214-2672
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Country | US
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Telephone | 469-626-8116
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | WHITNEY RUSSELL
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Credential | LPC
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Telephone | 469-626-8116
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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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