Provider Demographics
NPI:1033864160
Name:SANCTUARY PSYCHOLOGY
Entity Type:Organization
Organization Name:SANCTUARY PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEISSNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-373-4557
Mailing Address - Street 1:57 W 57TH ST STE 1101
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2814
Mailing Address - Country:US
Mailing Address - Phone:800-381-7340
Mailing Address - Fax:
Practice Address - Street 1:57 W 57TH ST STE 1101
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2814
Practice Address - Country:US
Practice Address - Phone:800-381-7340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health