Organization
SACRED SPACE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DECKERT LPC (PRESIDENT)
(616) 405-4188
Entity
Organization
Contact information
Practice address
17214 VAN WAGONER RD, SPRING LAKE, MI 49456-9702
(616) 405-4188
(616) 935-1288
Mailing address
17214 VAN WAGONER RD, SPRING LAKE, MI 49456-9702
(616) 405-4188
(616) 935-1288
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401009234
MI
Other
Enumeration date
08/29/2012
Last updated
05/12/2015
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