SACRED SPACES COUNSELING, LLC
NPI 1093309361
Social Worker - Clinical in Jacksonville, FL
About Sacred Spaces Counseling, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SACRED SPACES COUNSELING, LLC (NPI 1093309361) is a healthcare organization registered as a clinical in Jacksonville, Florida and active in the NPI registry since February 2021. The organization maintains a secondary practice location in Jacksonville and lists Teresa Ann Moore, Owner/therapist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Sacred Spaces Counseling, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Sacred Spaces Counseling, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sacred Spaces Counseling, LLC's NPI number?
The NPI number for Sacred Spaces Counseling, LLC is 1093309361. It was assigned to this organization in the NPPES registry on February 26, 2021.
Where is Sacred Spaces Counseling, LLC located?
Sacred Spaces Counseling, LLC is located at 8825 Perimeter Park Blvd Ste 601, Jacksonville, FL 32216. The listed phone number is (904) 885-0724.
What is Sacred Spaces Counseling, LLC's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Sacred Spaces Counseling, LLC enrolled in Medicare?
Yes. Sacred Spaces Counseling, LLC is registered in the Medicare PECOS enrollment system.
When is Sacred Spaces Counseling, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Sacred Spaces Counseling, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Sacred Spaces Counseling, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Sacred Spaces Counseling, LLC was last updated on February 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sacred Spaces Counseling, Llc · NPI 1093309361
Clinical organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since February 26, 2021.
## Identity
- **NPI:** 1093309361 (Entity type: Organization)
- **Enumerated:** February 26, 2021
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **Organization subpart:** No
- **Authorized official:** Teresa Moore, OWNER/THERAPIST
## Practice location
- **Address:** 8825 PERIMETER PARK BLVD STE 601, Jacksonville, FL 32216-1122
- **Phone:** (904) 885-0724 · **Fax:** (904) 409-3464
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Clinical Social Worker) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 26, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1093309361) · Data from the CMS NPPES public registry.