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Organization
SAGE MENTAL WELLNESS
Active
Organization
SAGE MENTAL WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDRA WORTHINGTON (OWNER)
(240) 310-9961
Entity
Organization
Contact information
Practice address
309 E PATRICK ST, FREDERICK, MD 21701-6792
(253) 355-5342
Mailing address
250 ANTIETAM DR, FALLING WATERS, WV 25419-4880
(253) 355-5342
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
05/31/2024
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