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Organization
SACRED SPACE CHRISTIAN COUNSELING LLC
Active
Organization
SACRED SPACE CHRISTIAN COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN WAGNER LSW, LPCC-S (OWNER)
(419) 438-6465
Entity
Organization
Contact information
Practice address
1150 N OTTOKEE ST, WAUSEON, OH 43567-1912
(419) 330-4141
(419) 330-4171
Mailing address
13361 COUNTY ROAD C2, HOLGATE, OH 43527-9628
(419) 438-6465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/20/2025
Last updated
06/20/2025
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