Provider Demographics
NPI:1043962947
Name:SAGE THERAPY
Entity type:Organization
Organization Name:SAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TEEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-537-6837
Mailing Address - Street 1:2716 GASTON LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6989
Mailing Address - Country:US
Mailing Address - Phone:619-537-6837
Mailing Address - Fax:
Practice Address - Street 1:2425 GEORGE MASON DR STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-3400
Practice Address - Country:US
Practice Address - Phone:619-537-6837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty