NPIMap

Organization Active NPI

Sacred Spaces LLC

  • Clinical Social Worker
  • West Valley City, UT
National Provider Identifier
1104699693
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SACRED SPACES LLC
Practice address
7296 W Sentinal Rd
West Valley City, UT 84081-6072
Phone
(801) 815-6905
NPI assigned
Nov 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Aleksandra Micic, LCSWNPI 1538592944
Title
Owner
Phone
(801) 815-6905

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

7296 W Sentinal Rd
West Valley City, UT 84081-6072

Mailing address

7296 W Sentinal Rd
West Valley City, UT 84081-6072
Phone (801) 815-6905

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1104699693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7296 W SENTINAL RD",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "840816072",
            "telephone_number": "801-815-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7296 W SENTINAL RD",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "840816072",
            "telephone_number": "801-815-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED SPACES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "MICIC",
        "authorized_official_first_name": "ALEKSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-815-6905",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.