Provider Demographics
NPI:1043194368
Name:THE SACRED INTUITION STUDIO
Entity type:Organization
Organization Name:THE SACRED INTUITION STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNTRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-224-6346
Mailing Address - Street 1:505 HOLIDAY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-2150
Mailing Address - Country:US
Mailing Address - Phone:979-224-6346
Mailing Address - Fax:
Practice Address - Street 1:215 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6739
Practice Address - Country:US
Practice Address - Phone:979-224-6346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty