Provider Demographics
NPI:1215761903
Name:SAGE COUNSELING COLLECTIVE, LLC
Entity type:Organization
Organization Name:SAGE COUNSELING COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-373-6477
Mailing Address - Street 1:10713 NW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7339
Mailing Address - Country:US
Mailing Address - Phone:405-373-6477
Mailing Address - Fax:
Practice Address - Street 1:10713 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7339
Practice Address - Country:US
Practice Address - Phone:405-373-6477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty