Sage Community Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904007725 Issued in VA

Legal business name

SAGE COMMUNITY COUNSELING LLC

Practice address

2239B Tacketts Mill Dr
Woodbridge, VA 22192-3026

Phone

(703) 508-3565

Fax

(866) 377-6092

NPI assigned

Feb 2, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Paula Jean Flynn, LCSW

Title

Principle

Phone

(703) 508-3565

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517529600000",
    "number": "1003315391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 HARBOR SIDE ST",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915470",
            "telephone_number": "703-508-3565",
            "fax_number": "866-377-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239B TACKETTS MILL DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221923026",
            "telephone_number": "703-508-3565",
            "fax_number": "866-377-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE COMMUNITY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRINCIPLE",
        "authorized_official_telephone_number": "703-508-3565",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.