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General NPI Number Information
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NPI Number | 1730792698
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Entity Type | Organization
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Legal Business Name | HOUSE OF THE SACRED JOURNEY INC
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 1920 7TH ST
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City | LAS VEGAS
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State | NM
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Zip | 87701-4956
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Country | US
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Telephone | 505-429-3980
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 7TH ST
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City | LAS VEGAS
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State | NM
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Zip | 87701-4956
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Country | US
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Telephone | 505-429-3980
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICIA D RODRIGUEZ
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Credential | LPCC, LSP,LED
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Telephone | 505-429-3980
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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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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #10
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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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Taxonomy #11
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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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