Healthcare Provider Details

I. General information

NPI: 1932053865
Provider Name (Legal Business Name): SACRED SELF-CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HAUPTSTRASSE #32
APO AE
66851
US

IV. Provider business mailing address

6421 N FLORIDA AVE # D-1665
TAMPA FL
33604-6007
US

V. Phone/Fax

Practice location:
  • Phone: 813-544-3489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DORA G FITZPATRICK
Title or Position: FOUNDER/OWNER
Credential: LCSW
Phone: 813-544-3489