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General NPI Number Information
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NPI Number | 1639718208
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Entity Type | Organization
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Legal Business Name | SANCTUARY WELLNESS AND EDUCATION, LLC.
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Dates
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Enumeration Date | 12/31/2019
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 3401 ENTERPRISE PKWY STE 340
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City | BEACHWOOD
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State | OH
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Zip | 44122-7340
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Country | US
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Telephone | 216-273-6020
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Fax | 216-998-0246
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Provider Business Mailing Address
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Address Line | 5110 ABIGAIL DR
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City | LYNDHURST
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State | OH
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Zip | 44124-1077
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Country | US
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Telephone | 216-273-6020
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Fax | 216-998-0246
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Authorized Official
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Title or Position | SCHOOL PSYCHOLOGIST
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Name | CHAQUITA NIAMKE
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Credential | PSY.S., LSPSY
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Telephone | 216-273-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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