=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770442592
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SANCTUARY TRAUMA & HEALING COLLECTIVE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2026
-----------------------------------------------------
Last Update Date | 01/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 550 CLEVELAND AVE STE 215
-----------------------------------------------------
City | CHAMBERSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17201-3442
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-693-4872
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23 ROMANCE LN
-----------------------------------------------------
City | CHAMBERSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17202-7030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JESSE HUNDLEY
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 717-693-4872
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------