SAGE INSTITUTE FOR PSYCHEDELIC THERAPY (NPI# 1679126221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679126221 |
Entity Type | Organization |
Organization Name | SAGE INSTITUTE FOR PSYCHEDELIC THERAPY |
Practice Address |
3007 Telegraph Ave Oakland CA 94609-3205 |
Mailing Address |
430 40th St Oakland CA 94609-2691 |
Practice Telephone | 4156891580 |
Mailing Telephone | 4156891580 |
Enumeration Date | 2019-07-23 |
Last Update Date | 2019-07-23 |
Authorized Official Name | DR. JASON BUTLER (TRAINING DIRECTOR) |
Authorized Official Telephone | 4156891580 |
Authorized Official Credential | PHD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
Street Address |
3007 TELEGRAPH AVE |
City | OAKLAND |
State | CA |
Zip Code | 94609-3205 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932327939 | Sharon Nelson | Social Worker | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2007-04-23 |
1063902096 | Irina Alexander | Marriage & Family Therapist | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2018-05-15 |
1073769402 | The West Oakland Health Council | Public Health or Welfare | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2008-08-18 |
1750546255 | La Keshia C Coleman | Counselor | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2008-07-23 |
1467636795 | Deborah James | Registered Nurse | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2007-12-21 |
1083816326 | Edward Jackson | Counselor | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2007-05-31 |
1154522159 | Ola Fuller Bennett | Social Worker | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2007-05-29 |
1932310513 | Willie Mae Owens | Counselor | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2007-05-24 |
1043421621 | Brenda Watson | Counselor | 3007 Telegraph Ave, Oakland, CA 94609-3205 | 2007-05-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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Taxonomy Code | 103T00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
Notes: Source: American Psychological Association [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326661430 | Gina M Arias | Psychologist | 3287 Madera Ave, Oakland, CA 94619-3412 | 2020-05-22 |
1871127464 | Karena Berghold Passaro | Psychologist | 5665 College Ave Ste 230d, Oakland, CA 94618-1639 | 2020-02-24 |
1053883025 | Lindsey Brooke Hopkins | Psychologist | 287 17th St Ste A, Oakland, CA 94612-4191 | 2018-12-31 |
1164903563 | Mindhealth, A Professional Psychology Corporation | Psychologist | 585 Mandana Blvd Ste 1, Oakland, CA 94610-2265 | 2018-08-23 |
1306338892 | Mark Fromm | Psychologist | 3296 Jordan Rd, Oakland, CA 94602-3535 | 2018-05-31 |
1205363199 | Holly Lynn Buckman | Psychologist | 1440 Broadway Ste 314, Oakland, CA 94612-2023 | 2017-05-22 |
1871942904 | Terri Marie Rech | Psychologist | 5835 College Ave Ste C, Oakland, CA 94618-1653 | 2016-06-09 |
1760867329 | William Barone | Psychologist | 360 Monte Vista Ave Apt 309, Oakland, CA 94611-4559 | 2015-07-24 |
1568853067 | Jason Carpenter | Psychologist | 715 62nd St, Oakland, CA 94609-1213 | 2015-02-05 |
1235535568 | Monique Thompson | Psychologist | 5297 College Ave # 206, Oakland, CA 94618-1462 | 2014-11-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.