Active NPI
Sandi Lea Sage, PH.D, LMHC
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1417144452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH5353
- Practice address
- 10752 Deerwood Park Blvd
Suite 100
Jacksonville, FL 32256-4849 - Phone
- (904) 394-2903
- Fax
- (904) 394-2904
- NPI assigned
- Oct 3, 2007
- Last updated
- Mar 16, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MH5353 | FL | |
| Mental Health Counselor | 101YM0800X | MH5353 | FL | Primary |
Addresses
Primary practice location
10752 Deerwood Park Blvd
Suite 100
Jacksonville, FL 32256-4849
Mailing address
10752 Deerwood Park Blvd
Suite 100
Jacksonville, FL 32256-4849
Phone (904) 394-2903
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z0439 | Other | FL | BCBS FL |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH5353 | FL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300233600000",
"number": "1417144452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10752 DEERWOOD PARK BLVD",
"address_2": "SUITE 100",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322564849",
"telephone_number": "904-394-2903",
"fax_number": "904-394-2904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10752 DEERWOOD PARK BLVD",
"address_2": "SUITE 100",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322564849",
"telephone_number": "904-394-2903",
"fax_number": "904-394-2904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAGE",
"first_name": "SANDI",
"middle_name": "LEA",
"name_prefix": "Dr.",
"credential": "PH.D, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-03",
"last_updated": "2011-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "FL",
"license": "MH5353",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH5353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FL",
"identifier": "Z0439",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
- Sage Dental of Jacksonville at Town Center PLLC
- Sage Dental of Jacksonville Glen Kernan, PLLC
- Sage Dental of Jacksonville Marietta PLLC
- Sage Dental of Jacksonville Midtown PLLC
- Sage Dental of Jacksonville Southside PLLC
- Sagepoint Care Agency LLC
- Mylouse Millie Sagesse
- Syed Hamad Sagheer, MD
- Venkata S Sagi, M.D.
- Jennifer Kay Sagle, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.