Provider Demographics
NPI:1033976915
Name:SANCTUARY COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:SANCTUARY COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:EDMUNDS
Authorized Official - Last Name:GUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CHTP
Authorized Official - Phone:336-399-3897
Mailing Address - Street 1:433 W END BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-1120
Mailing Address - Country:US
Mailing Address - Phone:336-399-3897
Mailing Address - Fax:
Practice Address - Street 1:433 W END BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-1120
Practice Address - Country:US
Practice Address - Phone:336-399-3897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty