NPIMap

Organization Active NPI

Sage Social Services, PA

  • Professional Counselor
  • Converse, TX
National Provider Identifier
1073800892
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
20064 Issued in TX
Legal business name
SAGE SOCIAL SERVICES, PA
Practice address
101 Peaceful LN
Converse, TX 78109-1007
Phone
(210) 248-9077
Fax
(210) 945-8489
NPI assigned
Jun 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Authorized official

Name
Mrs. Glenda Wrenn-Gordon, MD
Title
Owner
Phone
(210) 248-9077

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 20064 TX Primary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 27796 TX
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

101 Peaceful LN
Converse, TX 78109-1007

Mailing address

101 Peaceful LN
Converse, TX 78109-1007
Phone (210) 248-9077

National Provider Directory

National Provider Directory
Tax ID family
Sage Social Services PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1073800892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PEACEFUL LN",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781091007",
            "telephone_number": "210-248-9077",
            "fax_number": "210-945-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PEACEFUL LN",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781091007",
            "telephone_number": "210-248-9077",
            "fax_number": "210-945-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE SOCIAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "WRENN-GORDON",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-248-9077",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "20064",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "27796",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Converse, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.