| Sage Counseling Associates, Llc | |
|
1690 Stone Village Ln Nw Ste 602 Kennesaw GA 30152-7777 | |
| (770) 218-9005 | |
| Not Available |
| Full Name | Sage Counseling Associates, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1690 Stone Village Ln Nw Ste 602, Kennesaw, Georgia |
| Authorized Official Name and Position | Tiffany Tufford (CEO) |
| Authorized Official Contact | 4042265255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Counseling Associates, Llc 1690 Stone Village Ln Nw Ste 602 Kennesaw GA 30152-7777 Ph: (770) 954-8127 | Sage Counseling Associates, Llc 1690 Stone Village Ln Nw Ste 602 Kennesaw GA 30152-7777 Ph: (770) 218-9005 |
| NPI Number | 1447649066 |
|---|---|
| Provider Enumeration Date | 01/20/2015 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/06/2023 |
| Medicare PECOS PAC ID | 4880036128 |
|---|---|
| Medicare Enrollment ID | O20240531001571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447649066 | NPI | - | NPPES |
| 1427326057 | Other | GA | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC007587 (Georgia) | Primary |
| Provider Name | Tiffany Dixon Tufford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427326057 PECOS PAC ID: 9234571571 Enrollment ID: I20240531001998 |
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