Provider Demographics
NPI:1689431751
Name:SAGE MENTAL HEALTH PLC
Entity type:Organization
Organization Name:SAGE MENTAL HEALTH PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBOEUF
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:802-535-2176
Mailing Address - Street 1:374 EMERSON FALLS RD
Mailing Address - Street 2:BOX 2
Mailing Address - City:ST. JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-8865
Mailing Address - Country:US
Mailing Address - Phone:802-255-8788
Mailing Address - Fax:
Practice Address - Street 1:374 EMERSON FALLS RD STE 201
Practice Address - Street 2:
Practice Address - City:SAINT JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819
Practice Address - Country:US
Practice Address - Phone:802-255-8788
Practice Address - Fax:802-200-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty