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Organization
SAGE SOCIAL SERVICES, PC
Active
Organization
SAGE SOCIAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELANIE MARIE HENNIS LPC (LICENSED PROFESIONAL COUNSELOR)
(210) 725-3413
Entity
Organization
Contact information
Practice address
101 PEACEFUL LN, CONVERSE, TX 78109-1007
(210) 725-3413
(210) 945-8489
Mailing address
101 PEACEFUL LN, CONVERSE, TX 78109-1007
(210) 725-3413
(210) 945-8489
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
20064
TX
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20064
TX LIC NUMBER
TX
Enumeration date
08/29/2007
Last updated
03/04/2020
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