| Sacred Space Counseling Llc | |
|
750 Buckaroo Trl Sisters OR 97759-9427 | |
| (541) 419-6226 | |
| Not Available |
| Full Name | Sacred Space Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 750 Buckaroo Trl, Sisters, Oregon |
| Authorized Official Name and Position | Brianna Morzov (OWNER/OPERATOR) |
| Authorized Official Contact | 5414196226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Space Counseling Llc Po Box 285 Sisters OR 97759-0285 Ph: (541) 419-6226 | Sacred Space Counseling Llc 750 Buckaroo Trl Sisters OR 97759-9427 Ph: (541) 419-6226 |
| NPI Number | 1578120382 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 01/29/2021 |
| Certification Date | 01/29/2021 |
| Medicare PECOS PAC ID | 6002149580 |
|---|---|
| Medicare Enrollment ID | O20190617000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578120382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brianna C Morzov |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013246453 PECOS PAC ID: 6709189665 Enrollment ID: I20160127000448 |
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