Open Space LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

OPEN SPACE LLC

Practice address

402 Gammon PL Ste 290
Madison, WI 53719-1075

Phone

(608) 370-9063

NPI assigned

Jul 26, 2024

Organization subpart

No

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

Authorized official

Name

Sara JordanNPI 1649493917

Title

Owner/Director

Phone

(608) 370-9063

Specialties & licenses 1

Addresses

Other names 1

• Open Space LLC Doing business as

Practitioners 1

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

• Sara Jordan, LPC

  • Professional Counselor
  • Madison, WI
  • NPI 1649493917
  NPD Authorized official

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1194553404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 TOCORA LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111222",
            "telephone_number": "608-370-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 GAMMON PL STE 290",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191075",
            "telephone_number": "608-370-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN SPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "608-370-9063"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open Space LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.