| Sacred Space Counseling Naples | |
|
2575 Northbrooke Plaza Dr Unit 206 Naples FL 34119-8099 | |
| (815) 261-6285 | |
| Not Available |
| Full Name | Sacred Space Counseling Naples |
|---|---|
| Speciality | Counselor |
| Location | 2575 Northbrooke Plaza Dr Unit 206, Naples, Florida |
| Authorized Official Name and Position | Mary Mathias (OWNER) |
| Authorized Official Contact | 8152616285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Space Counseling Naples 2575 Northbrooke Plaza Dr Unit 206 Naples FL 34119-8099 Ph: (815) 261-6285 | Sacred Space Counseling Naples 2575 Northbrooke Plaza Dr Unit 206 Naples FL 34119-8099 Ph: (815) 261-6285 |
| NPI Number | 1215671326 |
|---|---|
| Provider Enumeration Date | 04/25/2022 |
| Last Update Date | 07/24/2022 |
| Certification Date | 06/29/2022 |
| Medicare PECOS PAC ID | 6901283126 |
|---|---|
| Medicare Enrollment ID | O20220509002432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215671326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Mary Mathias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508387325 PECOS PAC ID: 4082977525 Enrollment ID: I20220509002458 |
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