Healthcare Provider Details

I. General information

NPI: 1093643082
Provider Name (Legal Business Name): SANASANA MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 S 1ST ST
COTTAGE GROVE OR
97424-2138
US

IV. Provider business mailing address

PO BOX 897
CRESWELL OR
97426-0897
US

V. Phone/Fax

Practice location:
  • Phone: 541-731-3636
  • Fax:
Mailing address:
  • Phone: 541-239-3668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA HECKATHORN
Title or Position: OWNER
Credential: LCSW, CCM
Phone: 541-731-3636