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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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