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General NPI Number Information
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NPI Number | 1366655797
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Entity Type | Organization
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Legal Business Name | SANCTUARY COUNSELING LLC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 1125 BEN FRANKLIN HWY W
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City | DOUGLASSVILLE
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State | PA
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Zip | 19518-1829
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Country | US
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Telephone | 610-385-3155
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 BEN FRANKLIN HWY W
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City | DOUGLASSVILLE
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State | PA
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Zip | 19518-1829
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Country | US
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Telephone | 610-385-3155
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | HEATHER A KRAMER ALMQUIST
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Credential | LPC, MA, CT, NCP
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Telephone | 215-740-1855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | PC007092
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC007092
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC007092
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License Number State | PA
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