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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