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General NPI Number Information
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NPI Number | 1043963523
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Entity Type | Organization
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Legal Business Name | SANCTUARY COUNSELING & CONSULTING
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 12800 WHITEWATER DR
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City | MINNETONKA
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State | MN
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Zip | 55343-9441
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Country | US
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Telephone | 952-412-6997
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Fax |
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Provider Business Mailing Address
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Address Line | 5823 CROSSANDRA ST SE
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City | PRIOR LAKE
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State | MN
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Zip | 55372-3337
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Country | US
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Telephone | 952-412-6997
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Fax |
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Authorized Official
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Title or Position | OWNER; PSYCHOTHERAPIST
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Name | MRS. NANCY PHYLLIS RICH
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Credential | MSW LICSW
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Telephone | 952-412-6997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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