Sacred Spaces, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SACRED SPACES, INC

Practice address

380 W Palatine Rd
Suite 6
Wheeling, IL 60090-5831

Phone

(847) 947-7646

Fax

(847) 947-7645

NPI assigned

Apr 5, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Maria A Caruso, MSW, LCSW

Title

President

Phone

(847) 947-7646

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Melinda Alice Marx, MSW

  • Clinical Social Worker
  • Buffalo Grove, IL
  • NPI 1851352801

  Clinical

  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720040595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W PALATINE RD",
            "address_2": "SUITE 6",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600905831",
            "telephone_number": "847-947-7646",
            "fax_number": "847-947-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W PALATINE RD",
            "address_2": "SUITE 6",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600905831",
            "telephone_number": "847-947-7646",
            "fax_number": "847-947-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED SPACES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARUSO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-947-7646",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL PIN",
            "identifier": "4932184",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helena Ruderman, D.D.S.
• Kristina T Russell, LCSW
• Yakov Ryabov, MD
• Vicky P Ryan
• Violetta Rychcik, PTA
• Lauren Michelle Saetre, ED.S., NCSP
• Rustam Safarov, FNP
• Clive A Salvacion, PT
• Sam'S Club Optical
• San Fernando Healthcare Inc

• All providers in Wheeling, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.