MEDICARE: SAGE PSYCHOTHERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1023673035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGE PSYCHOTHERAPY

Provider Business Mailing Address
First Line	:	PO BOX 16952
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-6952
Country	:	US
Telephone Number	:	406-471-8869
Fax Number	:

Provider Business Practice Location Address
First Line	:	913 SW HIGGINS AVE STE 202
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59803-1423
Country	:	US
Telephone Number	:	406-471-8869
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MS. PAISLEY L. MILES
Credential	:	LCSW
Telephone Number	:	406-207-2680

Provider Enumeration Date	:	05/06/2019
Last Update Date	:	12/11/2025

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Directions to “SAGE PSYCHOTHERAPY ” Practice Location

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