Sacred Healing Therapeutic Services LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

SACRED HEALING THERAPEUTIC SERVICES LLC

Practice address

6144 Devon St
Portage, MI 49024-2648

Phone

(734) 709-2096

NPI assigned

Mar 26, 2018

Last updated

Feb 3, 2022By 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

Mary Beth Houpt

Title

Credentialing

Phone

(517) 676-9788

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

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.

• Tiffany Mazurek, LMSW

  • Clinical Social Worker
  • Portage, MI
  • NPI 1780008284
  Medicare reassignment NPD
• Allison Jordan, LMT, FDN-P

  • Massage Therapist
  • Livonia, MI
  • NPI 1881179893
  NPD (past)
• Robert Jay Koliner, D.C.

  • Chiropractor
  • Ann Arbor, MI
  • NPI 1689730699
  NPD (past)
• Stephen Lee Rassi, M.S.W., M.A.,PH.D.

  • Social Worker
  • Ann Arbor, MI
  • NPI 1811238793
  NPD (past)
• Carey A.E. Ryan, R. AC.

  • Acupuncturist
  • Ann Arbor, MI
  • NPI 1467894519
  NPD (past)

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1952806556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 DEVON ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242648",
            "telephone_number": "734-709-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEALING THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9788"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801075829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lee Russell, ED.D.
• RX Optical Laboratories, Inc.
• Stephanie Sabater-Geib, PA-C
• Sharon Roebuck Sabel, RN
• Thomas Sackett
• Safa Bahar Sadat
• Safe at Home Therapy LLC
• Benjamin David Sage, PA
• Jamie Gail Sage, D.D.S., M.S.
• Emily Salazar Romero

• Social Worker in Portage, MI
• Providers in Portage, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.