Provider Demographics
NPI:1124436654
Name:SAGE COUNSELING CONSULTANTS, L.L.C.
Entity type:Organization
Organization Name:SAGE COUNSELING CONSULTANTS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-S
Authorized Official - Phone:740-974-5832
Mailing Address - Street 1:2670 N COLUMBUS ST
Mailing Address - Street 2:SUITE K
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8408
Mailing Address - Country:US
Mailing Address - Phone:740-974-5832
Mailing Address - Fax:740-277-6555
Practice Address - Street 1:2670 N COLUMBUS ST
Practice Address - Street 2:SUITE K
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8408
Practice Address - Country:US
Practice Address - Phone:740-974-5832
Practice Address - Fax:740-277-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty