| Sacred Space Psychotherapy Llc | |
|
1668 E Pollino St San Tan Valley AZ 85140-7861 | |
| (480) 734-3391 | |
| (602) 641-8483 |
| Full Name | Sacred Space Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1668 E Pollino St, San Tan Valley, Arizona |
| Authorized Official Name and Position | Christine M Hoffman (MEMBER/OWNER/THERAPIST) |
| Authorized Official Contact | 4807343391 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Space Psychotherapy Llc 1668 E Pollino St San Tan Valley AZ 85140-7861 Ph: (480) 734-3391 | Sacred Space Psychotherapy Llc 1668 E Pollino St San Tan Valley AZ 85140-7861 Ph: (480) 734-3391 |
| NPI Number | 1306431754 |
|---|---|
| Provider Enumeration Date | 03/08/2021 |
| Last Update Date | 05/09/2023 |
| Certification Date | 05/09/2023 |
| Medicare PECOS PAC ID | 9537506217 |
|---|---|
| Medicare Enrollment ID | O20240318003576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306431754 | NPI | - | NPPES |
| Provider Name | Christine Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558657296 PECOS PAC ID: 4284865296 Enrollment ID: I20140314000987 |
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