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General NPI Number Information
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NPI Number | 1598680142
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Entity Type | Organization
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Legal Business Name | THE SANCTUARY SPACE, LLC
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 929 LOMBARD ST APT 206
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City | PHILADELPHIA
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State | PA
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Zip | 19147-1264
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Country | US
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Telephone | 267-225-2722
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Fax |
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Provider Business Mailing Address
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Address Line | 929 LOMBARD ST APT 206
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City | PHILADELPHIA
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State | PA
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Zip | 19147-1264
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Country | US
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Telephone | 267-225-2722
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Fax |
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Authorized Official
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Title or Position | ART THERAPIST AND COUNSELOR
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Name | CHELSEA FAULKNER
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Credential | MA, ATR, LAPC
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Telephone | 267-225-2722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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