Sacred Space Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SACRED SPACE PSYCHOTHERAPY LLC

Practice address

1668 E Pollino St
San Tan Valley, AZ 85140-7861

Phone

(480) 734-3391

Fax

(602) 641-8483

NPI assigned

Mar 8, 2021

Organization subpart

No

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

Authorized official

Name

Christine M Hoffman, LCSWNPI 1558657296

Title

Member/Owner/Therapist

Phone

(480) 734-3391

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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

• Christine M Hoffman, LCSW

  • Clinical Social Worker
  • San Tan Valley, AZ
  • NPI 1558657296
  Medicare reassignment NPD Authorized official
• Carolyn E Bowering

  • Medical Physician Assistant
  • Pasadena, MD
  • NPI 1558012583
  NPD (past)

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1306431754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 E POLLINO ST",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407861",
            "telephone_number": "480-734-3391",
            "fax_number": "602-641-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 E POLLINO ST",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407861",
            "telephone_number": "480-734-3391",
            "fax_number": "602-641-8483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3651 E Baseline Rd Ste E-222",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342689",
            "country_code": "US",
            "telephone_number": "480-734-3391",
            "fax_number": "602-641-8483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SACRED SPACE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER/OWNER/THERAPIST",
        "authorized_official_telephone_number": "480-734-3391",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanine Ruby, RPH
• Brian Michael Ruder
• Nathan E Russell, MD
• Barbara Izabela Rutkowski, FNP-C
• RW Therapy Care, LLC
• Safe Haven in Home Care
• Sail Homes LLC
• Anna Salibi
• Ryan Salter
• Janelle T Sammy, SOCIAL WORKER, LMSW

• Clinical Social Worker in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.