Provider Demographics
NPI:1144692930
Name:SAGE COUNSELING LLC
Entity type:Organization
Organization Name:SAGE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANCATO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:484-427-4673
Mailing Address - Street 1:3625 CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3602
Mailing Address - Country:US
Mailing Address - Phone:484-427-4673
Mailing Address - Fax:
Practice Address - Street 1:3625 CHAPEL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3602
Practice Address - Country:US
Practice Address - Phone:484-427-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5862101YA0400X
PASW130059104100000X
PASW130178104100000X
PACW0187121041C0700X
PACW0159751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty