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Organization

SANE SPACE PLLC

Active
Other names
Sane Space LLC, Sane Space
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINA JACKSON MS (OWNER)
(304) 220-0041
Entity
Organization

Contact information

Practice address
4421 EMERSON AVE STE 204, PARKERSBURG, WV 26104-1200
(304) 220-0441
(304) 220-0112
Mailing address
4421 EMERSON AVE STE 204, PARKERSBURG, WV 26104-1200
(304) 220-0441
(304) 220-0112

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YP2500X
Professional Counselor
103T00000X
Psychologist
Primary
103TC1900X
Counseling Psychologist

Other

Enumeration date
04/17/2023
Last updated
01/08/2025
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