Provider Demographics
NPI:1710581707
Name:SAFE SPACE THERAPEUTIC, PLLC
Entity type:Organization
Organization Name:SAFE SPACE THERAPEUTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SATCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:832-422-8356
Mailing Address - Street 1:12323 JOHNS PURCHASE CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2154
Mailing Address - Country:US
Mailing Address - Phone:832-422-8356
Mailing Address - Fax:
Practice Address - Street 1:17110 HOUSE HAHL RD., SUITE C-09
Practice Address - Street 2:SUITE C 09
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7946
Practice Address - Country:US
Practice Address - Phone:832-422-8356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty