Provider Demographics
NPI:1366979130
Name:BIERSTER, SAGE (LCSW)
Entity type:Individual
Prefix:
First Name:SAGE
Middle Name:
Last Name:BIERSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 FLORIDA ST APT 2
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3429
Mailing Address - Country:US
Mailing Address - Phone:917-520-4938
Mailing Address - Fax:
Practice Address - Street 1:1207 FLORIDA ST APT 2
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3429
Practice Address - Country:US
Practice Address - Phone:917-520-4938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical