NPIMap

Organization Active NPI

Sacred Space Psychotherapy, LLC

  • Clinical Psychologist
  • Covington, LA
National Provider Identifier
1679253199
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SACRED SPACE PSYCHOTHERAPY, LLC
Practice address
206 S Tyler St Ste B
Covington, LA 70433-3073
Phone
(504) 231-9274
NPI assigned
Jul 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Authorized official

Name
Dr. James Hernandez, PSY.D.NPI 1316313935
Title
Psychologist/Owner
Phone
(504) 231-9274

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

206 S Tyler St Ste B
Covington, LA 70433-3073

Mailing address

206 S Tyler St Ste B
Covington, LA 70433-3073
Phone (504) 231-9274

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.

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1679253199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S TYLER ST STE B",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333073",
            "telephone_number": "504-231-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S TYLER ST STE B",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333073",
            "telephone_number": "504-231-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED SPACE PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "504-231-9274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.