Provider Demographics
NPI:1114170404
Name:SACRED SPIRAL RESOURCES LLC
Entity Type:Organization
Organization Name:SACRED SPIRAL RESOURCES LLC
Other - Org Name:NANCY N. COHEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:NUTTING
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:651-686-8818
Mailing Address - Street 1:4141 OLD SIBLEY MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1996
Mailing Address - Country:US
Mailing Address - Phone:651-686-8818
Mailing Address - Fax:651-686-5560
Practice Address - Street 1:4141 OLD SIBLEY MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1996
Practice Address - Country:US
Practice Address - Phone:651-686-8818
Practice Address - Fax:651-686-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1194251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health