SANCTUARY COUNSELING, LLC (NPI# 1366075566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366075566 |
| Entity Type | Organization |
| Organization Name | SANCTUARY COUNSELING, LLC |
| Practice Address |
12247 S Racine Ave Calumet Park IL 60643 UM |
| Mailing Address |
12247 S Racine Ave Calumet Park IL 60643-5401 |
| Practice Telephone | 3126870198 |
| Mailing Telephone | 3126870198 |
| Enumeration Date | 2020-02-16 |
| Last Update Date | 2020-02-16 |
| Authorized Official Name | DR. CHRISTINE LANG REESE (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 3126870198 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SANCTUARY COUNSELING, LLC | 12247 S Racine Ave, Calumet Park, IL 60643-5401 |
| Street Address |
12247 S RACINE AVE |
| City | CALUMET PARK |
| State | IL |
| Zip Code | 60643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447885801 | Roy C Reese Jr. | Psychologist | 12247 S Racine Ave, Calumet Park, IL 60643-5401 | 2020-03-05 |
| 1790310159 | Sanctuary Community Counseling and Resources, Nfp | Community/Behavioral Health | 12247 S Racine Ave, Calumet Park, IL 60643-5401 | 2020-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| 1255853172 | Beverly Fowler | Specialist/Technologist | 11624 S. May Street, Chicago, IL 60643 | 2017-07-12 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1417556283 | Kjp Alliance LLC | Psychologist | 16595 W Easton Ave Ste 1, Lincolnshire, IL 60069-2744 | 2020-10-22 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1083212005 | Amanda Michele Long | Psychologist | 20280 Governors Hwy Ste 105, Olympia Fields, IL 60461-1068 | 2020-10-12 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1558978379 | Youngok Kim | Psychologist | 1260 Iroquois Ave Ste 204, Naperville, IL 60563-8548 | 2020-09-25 |
| 1861007049 | Heloisa Garman | Psychologist | 800 Elgin Rd Apt 1611, Evanston, IL 60201-5632 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
| City | CALUMET PARK |
| Zip Code | 60643 |
Please comment or provide details below to improve the information on SANCTUARY COUNSELING, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.