Organization Active NPI

Sage Counseling

  • Adult Mental Health Clinic/Center
  • Joliet, IL
National Provider Identifier
1891459525
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SAGE COUNSELING
Practice address
210 N Hammes Ave
Joliet, IL 60435-6680
Phone
(630) 649-9087
NPI assigned
Oct 28, 2021
Last updated
Oct 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Authorized official

Name
Mary Clare Carlson, LCPC
Title
Mental Health Therapist
Phone
(630) 649-9087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

210 N Hammes Ave
Joliet, IL 60435-6680

Mailing address

210 N Hammes Ave
Joliet, IL 60435-6680
Phone (630) 649-9087

Other identifiers 1

IdentifierTypeStateIssuer
180.009476OtherILIDPFR

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL GMAIL.COM

National Provider Directory

National Provider Directory

Locations

210 N Hammes Ave
Joliet, IL 60435
Phone (815) 725-6511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1891459525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356680",
            "telephone_number": "630-649-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356680",
            "telephone_number": "630-649-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "MARY CLARE",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "630-649-9087",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPFR",
            "identifier": "180.009476",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GMAIL.COM",
            "affiliation": "N",
            "address_1": "210 N Hammes Ave",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604356680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.