Sane Space PLLC
NPI 1164118642ActiveOrganization· Psychologist· Parkersburg, WV
Psychologist in Parkersburg, West Virginia, registered in NPPES in April 2023. The authorized official on file is Christina Jackson, MS, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164118642 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 17, 2023 |
| Last updated in NPPES | Jan 8, 2025 |
| Certified by provider | Dec 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
| Counselor | 101Y00000X | — | — |
| Counselor, Professional | 101YP2500X | — | — |
| Psychologist, Counseling | 103TC1900X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WV) |
|---|
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