Healthcare Provider Details
I. General information
NPI: 1821916305
Provider Name (Legal Business Name): SAFE SPACE HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4015 EXECUTIVE PARK DR STE 215
CINCINNATI OH
45241-2080
US
IV. Provider business mailing address
3822 SPRING HOUSE LN
CINCINNATI OH
45217-1920
US
V. Phone/Fax
- Phone: 513-341-8524
- Fax:
- Phone: 513-226-0592
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LATONYA
JEANNETTE
WHIPPLE
Title or Position: AGENT
Credential: PHD
Phone: 513-226-0592