Sacred Space Psychotherapy, LLC
Psychologist, Clinical in Covington, LA. Organization (NPI-2).
NPI number1679253199
StatusActive
Last updated in NPPESJul 19, 2023
Details
- NPI
- 1679253199
- Entity type
- Organization (NPI-2)
- Legal business name
- Sacred Space Psychotherapy, LLC
- Organization subpart
- No
- Enumeration date
- Jul 19, 2023
- Certification date
- Jul 19, 2023
- Last updated
- Jul 19, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
Practice location
206 S Tyler St Ste BCovington, LA 70433-3073
Phone 504-231-9274
Mailing address
206 S Tyler St Ste BCovington, LA 70433-3073
Phone 504-231-9274
Authorized official
James Hernandez
Psychologist/Owner
5042319274
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