| Sacred Space Psychotherapy, Llc | |
|
206 S Tyler St Ste B Covington LA 70433-3073 | |
| (504) 231-9274 | |
| Not Available |
| Full Name | Sacred Space Psychotherapy, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 206 S Tyler St Ste B, Covington, Louisiana |
| Authorized Official Name and Position | James Hernandez (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 5042319274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Space Psychotherapy, Llc 206 S Tyler St Ste B Covington LA 70433-3073 Ph: (504) 231-9274 | Sacred Space Psychotherapy, Llc 206 S Tyler St Ste B Covington LA 70433-3073 Ph: (504) 231-9274 |
| NPI Number | 1679253199 |
|---|---|
| Provider Enumeration Date | 07/19/2023 |
| Last Update Date | 07/19/2023 |
| Certification Date | 07/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679253199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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