Provider Demographics
NPI:1447649066
Name:SAGE COUNSELING ASSOCIATES, LLC
Entity type:Organization
Organization Name:SAGE COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:TUFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:404-226-5255
Mailing Address - Street 1:1690 STONE VILLAGE LN NW STE 602
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-7777
Mailing Address - Country:US
Mailing Address - Phone:770-954-8127
Mailing Address - Fax:844-289-6710
Practice Address - Street 1:1690 STONE VILLAGE LN NW STE 602
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7777
Practice Address - Country:US
Practice Address - Phone:770-218-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1427326057OtherPERSONAL NPI