Sacred Space, LLC

NPI #1679160063 in Gaithersburg, Maryland

Provider Information

NPI Number: 1679160063
Entity Type: Organization
Organization Name: Sacred Space, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Dec 31, 2020
Last Updated: Dec 31, 2020

Practice Location

Address: 19310 SHERWOOD GREEN WAY
City: Gaithersburg
State: Maryland
ZIP Code: 20879
Phone: (202) 567-7726

Authorized Official

Name: ARIELLE MESA, LICSW RYT
Title: CLINICAL SOCIAL WORKER
Phone: (202) 265-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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