| Organization Name: | SAGE SOCIAL SERVICES, PC |
| NPI Number: | 1073800892 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MELANIE HENNIS (FOUNDER/DIRECTOR) |
| Mailing Address: | 101 Peaceful Ln Converse |
| State: | TX US |
| Postal Code: | 781091007 |
| Phone Number: | 2102489077 |
| Fax Number: | 2109458489 |
| NPI Enumeration Date: | 06/30/2011 |
| NPI Last Update Date: | 06/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 27796 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |