Sacred Space Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1349 Issued in AK

Legal business name

SACRED SPACE THERAPY, LLC

Practice address

4325 Laurel St
Suite # 285
Anchorage, AK 99508-5364

Phone

(907) 929-4325

NPI assigned

Feb 4, 2015

Last updated

Feb 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Shana Gibney, L.C.S.W.

Title

Owner

Phone

(907) 929-4325

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1538559042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 LAUREL ST",
            "address_2": "SUITE # 285",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085364",
            "telephone_number": "907-929-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 LAUREL ST",
            "address_2": "SUITE # 285",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085364",
            "telephone_number": "907-929-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED SPACE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "GIBNEY",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-929-4325",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "1349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank David Sacco, MD
• Haleigh Sacks, FNP
• Jonathan Donald Sacks, FNP
• Sacred Heart Care Center
• Sacred Lotus Healing
• Mary Grace Saculles
• Shoshana Susan Sadow, LAC
• Norman Sadsad
• Elsie Low Saechao
• Kyle Kao Y Saelee

• Clinical Social Worker in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.