Provider Demographics
NPI:1043963523
Name:SANCTUARY COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:SANCTUARY COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER; PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:PHYLLIS
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:952-412-6997
Mailing Address - Street 1:5823 CROSSANDRA ST SE
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-3337
Mailing Address - Country:US
Mailing Address - Phone:952-412-6997
Mailing Address - Fax:
Practice Address - Street 1:12800 WHITEWATER DR
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9441
Practice Address - Country:US
Practice Address - Phone:952-412-6997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty