Sanctuary Counseling, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SANCTUARY COUNSELING, LLC

Practice address

12247 S Racine Ave
Calumet Park, IL 60643
UM

Phone

(312) 687-0198

NPI assigned

Feb 16, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Christine Lang Reese

Title

Clinical Psychologist

Phone

(312) 687-0198

Specialties & licenses 4

Addresses

Electronic endpoints 1

Interoperability endpoints

• Direct secure messaging: drchristine@sanctuarycounseling.org

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.

• Christine Reese, PSYD

  • Clinical Psychologist
  • Calumet Park, IL
  • NPI 1275057705
  NPD

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

{
    "created_epoch": "1581811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581811200000",
    "number": "1366075566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12247 S RACINE AVE",
            "city": "CALUMET PARK",
            "state": "IL",
            "postal_code": "606435401",
            "telephone_number": "312-687-0198"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "12247 S RACINE AVE",
            "city": "CALUMET PARK",
            "state": "IL",
            "postal_code": "60643",
            "telephone_number": "312-687-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-16",
        "last_updated": "2020-02-16",
        "certification_date": "2020-02-16",
        "status": "A",
        "authorized_official_last_name": "LANG REESE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-687-0198",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Drchristine@sanctuarycounseling.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Primary",
            "address_1": "12247 S Racine Ave",
            "city": "Calumet Park",
            "state": "IL",
            "country_code": "UM",
            "postal_code": "60643",
            "country_name": "United States Minor Outlying Islands",
            "address_type": "FGN"
        }
    ],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2020; 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.