NPIMap

Organization Active NPI

SSCN LLC

Doing business as Sacred Space Counseling Naples

  • Mental Health Counselor
  • Naples, FL
National Provider Identifier
1215671326
Registry record updated Jul 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SSCN LLC
Doing business as
Sacred Space Counseling Naples
Practice address
2575 Northbrooke Plaza Dr Unit 206
Naples, FL 34119-8099
Phone
(815) 261-6285
NPI assigned
Apr 25, 2022
Last updated
Jul 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2022

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

Authorized official

Name
Mary Mathias, LCSWNPI 1508387325
Title
Owner
Phone
(815) 261-6285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2575 Northbrooke Plaza Dr Unit 206
Naples, FL 34119-8099

Mailing address

2575 Northbrooke Plaza Dr Unit 206
Naples, FL 34119-8099
Phone (815) 261-6285

Other names 1

  • Sacred Space Counseling Naples Doing business as

National Provider Directory

National Provider Directory

Locations

12250 Tamiami Trl E
Apt 313
Naples, FL 34113
Phone (815) 261-6285

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658620800000",
    "number": "1215671326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 NORTHBROOKE PLAZA DR UNIT 206",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198099",
            "telephone_number": "815-261-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 NORTHBROOKE PLAZA DR UNIT 206",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198099",
            "telephone_number": "815-261-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSCN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-07-24",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "MATHIAS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-261-6285",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacred Space Counseling Naples",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sacred Space Counseling Naples",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.