Healthcare Provider Details

I. General information

NPI: 1073307922
Provider Name (Legal Business Name): THE HOLDING SPACE THERAPY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 MAIN ST
LINFIELD PA
19468-1019
US

IV. Provider business mailing address

1245 MAIN ST
LINFIELD PA
19468-1019
US

V. Phone/Fax

Practice location:
  • Phone: 856-701-7010
  • Fax: 856-701-7010
Mailing address:
  • Phone: 856-701-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: EMILY MCCREADY
Title or Position: CO-FOUNDER
Credential:
Phone: 856-701-7010