Active NPI
Sagan Marie King, PSY.D., LP, HSPP
- Clinical Psychologist
- Durham, NC
National Provider Identifier
1093377558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6491
- Practice address
- 1447 E NC Highway 54 Apt U
Durham, NC 27713-2672 - Phone
- (419) 771-0307
- NPI assigned
- Jul 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6491 | NC | Primary |
| Professional Counselor | 101YP2500X | 0701008243 | VA | |
| Mental Health Counselor | 101YM0800X | 39003210A | IN |
Addresses
Primary practice location
1447 E NC Highway 54 Apt U
Durham, NC 27713-2672
Mailing address
1447 E NC Highway 54 Apt U
Durham, NC 27713-2672
Phone (419) 771-0307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 13, 2023 through Dec 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39003210A | IN | MD | Mental Health Counselor |
| 0701008243 | VA | MD | Professional Counselor |
| 6491 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lepage Associates | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702425600000",
"number": "1093377558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1447 E NC HIGHWAY 54 APT U",
"city": "DURHAM",
"state": "NC",
"postal_code": "277132672",
"telephone_number": "419-771-0307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1447 E NC HIGHWAY 54 APT U",
"city": "DURHAM",
"state": "NC",
"postal_code": "277132672",
"telephone_number": "419-771-0307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "SAGAN",
"middle_name": "MARIE",
"credential": "PSY.D., LP, HSPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-05",
"last_updated": "2023-12-13",
"certification_date": "2023-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "6491",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701008243",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39003210A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.