Provider Demographics
NPI:1063960144
Name:ESPITIA, SAGE ANN (MS, LMHC, LPC)
Entity type:Individual
Prefix:
First Name:SAGE ANN
Middle Name:
Last Name:ESPITIA
Suffix:
Gender:F
Credentials:MS, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HEATHER GLEN DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5820
Mailing Address - Country:US
Mailing Address - Phone:214-729-5561
Mailing Address - Fax:
Practice Address - Street 1:120 HEATHER GLEN DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5820
Practice Address - Country:US
Practice Address - Phone:214-729-5561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60605613101YM0800X
TX86252101YM0800X
WALH60735586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health