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SANCTUARY PSYCHOTHERAPY SERVICES LLC NPI 1104563378


NPI Information

NPI: 1104563378
Provider Name: SANCTUARY PSYCHOTHERAPY SERVICES LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
5737 S WATTERSON TRL APT 5
LOUISVILLE, KY
ZIP 40291
Phone: (452) 744-4708
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SANCTUARY PSYCHOTHERAPY SERVICES LLC is a clinical social worker in Louisville, KY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. SANCTUARY PSYCHOTHERAPY SERVICES LLC NPI is 1104563378. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5737 S WATTERSON TRL APT 5
LOUISVILLE, KY
ZIP 40291-899
Phone: (452) 744-4708
Fax: (502) 331-6062

The provider's authorized official is Maria Wibbels .
The authorized official title is Owner and has the following contact phone number (845) 274-4470.

The enumeration date for this NPI number is 5/18/2022 and was last updated on 5/18/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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