| NPI | 1720775893 |
|---|---|
| Doing Business As | SAGE COUNSELING OF SOUTHERN ILLINOIS |
| Entity Type | Organization |
| Authorized Contact | CORTNEY M GRASSL Program Director 618-993-3013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2024-05-15 |