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General NPI Number Information
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NPI Number | 1982001103
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Entity Type | Organization
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Legal Business Name | SACRED STORIES IN THE SAND COUNSELING AND THERAPY
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 2008 COURTYARD LOOP APT 204
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City | SANFORD
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State | FL
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Zip | 32771-7444
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Country | US
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Telephone | 407-322-8064
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Fax |
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Provider Business Mailing Address
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Address Line | 3599 W LAKE MARY BLVD STE B
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City | LAKE MARY
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State | FL
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Zip | 32746-3417
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Country | US
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Telephone | 407-443-3371
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Fax | 407-328-7975
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Authorized Official
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Title or Position | LMHC, LPC
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Name | CASSANDRA DEANNA SAMS
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Credential | ED.S.
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Telephone | 407-443-3371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH8571
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License Number State | FL
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