Sacred Spaces Counseling, LLC
NPI 1093309361ActiveOrganization· Social Worker, Clinical· Jacksonville, FL
Social Worker, Clinical in Jacksonville, Florida, registered in NPPES in February 2021. The authorized official on file is Teresa Ann Moore, LCSW, Owner/Therapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1093309361 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 26, 2021 |
| Last updated in NPPES | Feb 26, 2021 |
| Certified by provider | Feb 25, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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