Sage Psychological Consulting, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

003723 Issued in GA

Legal business name

SAGE PSYCHOLOGICAL CONSULTING, LLC

Practice address

1718 Peachtree St NW
Suite 481
Atlanta, GA 30309-2452

Phone

(404) 317-2283

Fax

(404) 393-6692

NPI assigned

Sep 30, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Triphinia Margaret Wallace, PHD.

Title

Ceo/Owner

Phone

(404) 317-2283

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1346643715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4556 PARKVIEW SQ",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303499408",
            "telephone_number": "404-317-2283",
            "fax_number": "404-393-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 PEACHTREE ST NW",
            "address_2": "SUITE 481",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092452",
            "telephone_number": "404-317-2283",
            "fax_number": "404-393-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE PSYCHOLOGICAL CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TRIPHINIA",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "404-317-2283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "003723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.