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General NPI Number Information
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NPI Number | 1851923866
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Entity Type | Organization
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Legal Business Name | SANCTUARY PSYCHOTHERAPY AND WELLNESS, LLC
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Dates
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Enumeration Date | 02/07/2020
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 5561 S 48TH ST STE 201I
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City | LINCOLN
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State | NE
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Zip | 68516-4133
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Country | US
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Telephone | 402-840-4958
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Fax |
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Provider Business Mailing Address
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Address Line | 5561 S 48TH ST STE 201I
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City | LINCOLN
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State | NE
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Zip | 68516-4133
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | HOLLIE J URBAUER
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Credential | M.A., LMHP, LADC, CP
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Telephone | 402-840-4958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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