Organization Active NPI

Sage Child and Adolescent Services

  • Child & Adolescent Psychiatry Physician
  • Albuquerque, NM
National Provider Identifier
1306569041
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
SAGE CHILD AND ADOLESCENT SERVICES
Practice address
7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314
Phone
(505) 884-1114
Fax
(505) 884-3004
NPI assigned
Sep 19, 2022
Organization subpart
Yes
Parent organization
SAGE NEUROSCIENCE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Dr. Reuben Sutter, MD
Title
Ceo
Phone
(505) 884-1114

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314

Mailing address

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314
Phone (505) 884-1114

National Provider Directory

National Provider Directory
Part of
Sage Neuroscience Center Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1306569041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114",
            "fax_number": "505-884-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114",
            "fax_number": "505-884-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE CHILD AND ADOLESCENT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAGE NEUROSCIENCE CENTER INC",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "SUTTER",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-884-1114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.