Active NPI
Gregory Sage
- Mental Health Counselor
- Wixom, MI
National Provider Identifier
1255001178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6451019677
- Practice address
- 2009 Maple North TRL
Wixom, MI 48393-1867 - Phone
- (248) 787-5367
- NPI assigned
- Sep 14, 2021
- Last updated
- Sep 14, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6451019677 | MI | Primary |
Addresses
Primary practice location
2009 Maple North TRL
Wixom, MI 48393-1867
Mailing address
2009 Maple North TRL
Wixom, MI 48393-1867
Phone (248) 787-5367
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6451019677 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1255001178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2009 MAPLE NORTH TRL",
"city": "WIXOM",
"state": "MI",
"postal_code": "483931867",
"telephone_number": "248-787-5367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2009 MAPLE NORTH TRL",
"city": "WIXOM",
"state": "MI",
"postal_code": "483931867",
"telephone_number": "248-787-5367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAGE",
"first_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-14",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6451019677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wixom, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.