NPIMap

Organization Active NPI

Sacred Space Counseling

  • Professional Counselor
  • Spring Lake, MI
National Provider Identifier
1487902003
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401009234 Issued in MI
Legal business name
SACRED SPACE COUNSELING
Practice address
17214 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone
(616) 405-4188
Fax
(616) 935-1288
NPI assigned
Aug 29, 2012
Last updated
May 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Authorized official

Name
Robert Deckert, LPCNPI 1700134319
Title
President
Phone
(616) 405-4188

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 6401009234 MI Primary

Addresses

Primary practice location

17214 Van Wagoner Rd
Spring Lake, MI 49456-9702

Mailing address

17214 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone (616) 405-4188

National Provider Directory

National Provider Directory

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": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1487902003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17214 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-405-4188",
            "fax_number": "616-935-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17214 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-405-4188",
            "fax_number": "616-935-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED SPACE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "DECKERT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-405-4188",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.