Organization Active NPI

Sage Therapy Group, PLLC

  • Counselor
  • Dallas, TX
National Provider Identifier
1710430871
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
76078 Issued in TX
Legal business name
SAGE THERAPY GROUP, PLLC
Practice address
1910 Pacific Ave Ste 17090
Dallas, TX 75201-4828
Phone
(469) 232-4895
NPI assigned
Jul 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Dr. Sekou Fraser, PHD, LPCNPI 1942753298
Title
LPC
Phone
(469) 232-4895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 76078 TX Primary

Addresses

Primary practice location

1910 Pacific Ave Ste 17090
Dallas, TX 75201-4828

Mailing address

1910 Pacific Ave Ste 17090
Dallas, TX 75201-4828
Phone (469) 232-4895

National Provider Directory

National Provider Directory

Locations

1910 Pacific Ave
Ste 17090
Dallas, TX 75201
Phone (469) 232-4895

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1710430871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PACIFIC AVE STE 17090",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014828",
            "telephone_number": "469-232-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PACIFIC AVE STE 17090",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014828",
            "telephone_number": "469-232-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE THERAPY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "SEKOU",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "469-232-4895",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "76078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.