MEDICARE: SACRED CIRCLE COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1528904265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED CIRCLE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	117 E PICCADILLY ST STE 300
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-5002
Country	:	US
Telephone Number	:	304-315-2024
Fax Number	:	304-990-0371

Provider Business Practice Location Address
First Line	:	117 E PICCADILLY ST STE 300
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-5002
Country	:	US
Telephone Number	:	304-315-2024
Fax Number	:	304-990-0371

Authorized Official
Title or Position	:	OWNER
Name	:	KELLY MARIE SHERIDAN
Credential	:	MS, LMFT
Telephone Number	:	304-315-2024

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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