Organization
SAGE BEAR COUNSELING, LLC
Active
Organization
SAGE BEAR COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE GENEVIEVE DAVIDGE LCSW (LICENSED CLINICAL SOCIAL WORKER)
(505) 830-6030
Entity
Organization
Contact information
Practice address
3150 CARLISLE BLVD NE, SUITE 22, ALBUQUERQUE, NM 87110-1678
(505) 830-6030
(505) 830-6031
Mailing address
3150 CARLISLE BLVD NE, SUITE 22, ALBUQUERQUE, NM 87110-1678
(505) 830-6030
(505) 830-6031
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-1853
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95656
—
NM
Enumeration date
02/08/2016
Last updated
02/12/2016
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