| Safe Space Therapeutic, Pllc | |
|
17110 House Hahl Rd., Suite C-09 Suite C 09 Cypress TX 77433-7946 | |
| (832) 422-8356 | |
| Not Available |
| Full Name | Safe Space Therapeutic, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 17110 House Hahl Rd., Suite C-09, Cypress, Texas |
| Authorized Official Name and Position | Jaclyn Danielle Satchel (OWNER/OPERATOR) |
| Authorized Official Contact | 8324228356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Safe Space Therapeutic, Pllc 12323 Johns Purchase Ct Cypress TX 77433-2154 Ph: (832) 422-8356 | Safe Space Therapeutic, Pllc 17110 House Hahl Rd., Suite C-09 Suite C 09 Cypress TX 77433-7946 Ph: (832) 422-8356 |
| NPI Number | 1710581707 |
|---|---|
| Provider Enumeration Date | 11/30/2020 |
| Last Update Date | 08/09/2023 |
| Certification Date | 08/09/2023 |
| Medicare PECOS PAC ID | 8224483060 |
|---|---|
| Medicare Enrollment ID | O20231013000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710581707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jaclyn D Satchel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164084794 PECOS PAC ID: 7214344399 Enrollment ID: I20210408000728 |
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