Organization
SAGE BEHAVIORAL COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE WILMOT LCSW (LICENSED THERAPIST)
(541) 280-1570
Entity
Organization
Contact information
Practice address
25 NW PARK PL, BEND, OR 97701-2954
(541) 280-1570
Mailing address
1225 NW JACKSONVILLE AVE, BEND, OR 97701-2228
(541) 280-1570
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
77670496
OR
Other
Enumeration date
07/18/2011
Last updated
09/06/2011
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