Healthcare Provider Details

I. General information

NPI: 1467321026
Provider Name (Legal Business Name): SATTVA INTEGRATIVE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W LOWE AVE STE 102
FAIRFIELD IA
52556-2470
US

IV. Provider business mailing address

200 W LOWE AVE STE 102
FAIRFIELD IA
52556-2470
US

V. Phone/Fax

Practice location:
  • Phone: 320-395-1263
  • Fax: 888-346-2664
Mailing address:
  • Phone: 320-395-1263
  • Fax: 888-346-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA KNIGHT
Title or Position: LMFT/OWNER
Credential: MS
Phone: 320-295-1263