NPIMap

Organization Active NPI

Sage Therapy LLC

  • Speech-Language Pathologist
  • Cumming, GA
National Provider Identifier
1770961104
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007584 Issued in GA
Legal business name
SAGE THERAPY LLC
Practice address
2485 Vistoria Dr
Cumming, GA 30041-1579
Phone
(678) 977-7874
NPI assigned
May 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Authorized official

Name
Sage Jackson
Title
Speech Language Pathologist
Phone
(404) 514-6654

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SLP007584 GA Primary

Addresses

Primary practice location

2485 Vistoria Dr
Cumming, GA 30041-1579

Mailing address

2485 Vistoria Dr
Cumming, GA 30041-1579
Phone (678) 977-7874

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1770961104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 VISTORIA DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300411579",
            "telephone_number": "678-977-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 VISTORIA DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300411579",
            "telephone_number": "678-977-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-18",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SAGE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "404-514-6654"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.