Organization
SACRED SPACE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE MCMASTER (CLINICAL SOCIAL WORKER)
(937) 336-6950
Entity
Organization
Contact information
Practice address
1426 N HANCOCK AVE STE 5N, COLORADO SPRINGS, CO 80903-2672
(937) 336-6950
Mailing address
6010 APPLEWOOD RIDGE CIR, COLORADO SPRINGS, CO 80918-3305
(937) 336-6950
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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