Active NPI
Avery Michael Sage, LMSW
- Social Worker
- Branford, CT
National Provider Identifier
1235905985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9147
- Practice address
- 11 Sycamore Way
Branford, CT 06405-6552 - Phone
- (203) 800-7177
- NPI assigned
- Dec 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9147 | CT | Primary |
Addresses
Primary practice location
11 Sycamore Way
Branford, CT 06405-6552
Mailing address
11 Sycamore Way
Branford, CT 06405-6552
Phone (120) 392-7676
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1235905985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SYCAMORE WAY",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064056552",
"telephone_number": "120-392-7676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 SYCAMORE WAY",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064056552",
"telephone_number": "203-800-7177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAGE",
"first_name": "AVERY",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-04",
"last_updated": "2023-12-04",
"certification_date": "2023-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "9147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Branford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.