Sanctuary Psychotherapy Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SANCTUARY PSYCHOTHERAPY SERVICES LLC

Practice address

5737 S Watterson TRL Apt 5
Louisville, KY 40291-1899

Phone

(452) 744-4708

Fax

(502) 331-6062

NPI assigned

May 18, 2022

Last updated

May 18, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maria Wibbels, LCSWNPI 1114014636

Title

Owner

Phone

(845) 274-4470

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria L. Wibbels, L.C.S.W.

  • Clinical Social Worker
  • Louisville, KY
  • NPI 1114014636
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1104563378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5737 S WATTERSON TRL APT 5",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911899",
            "telephone_number": "845-274-4470",
            "fax_number": "502-331-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5737 S WATTERSON TRL APT 5",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911899",
            "telephone_number": "452-744-4708",
            "fax_number": "502-331-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY PSYCHOTHERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "WIBBELS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-274-4470",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gleydis Sanchez
• Jamie Sanchez, LCSW
• Kathryn Tinio Sanchez, M.D.
• Lisa Marie Sanchez, M.D.
• Nayelyi Lisabeth Sanchez
• Sandeep Kapoor, PLLC
• Ciara Sandefur, DMD
• Melissa Ann Sanderfer, PT
• Amanda Jane Sanders, PT, DPT
• Autumn Sanders

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.