Provider Demographics
NPI: | 1013537778 |
---|---|
Name: | INNER GUIDANCE COUNSELING LLC |
Entity Type: | Organization |
Organization Name: | INNER GUIDANCE COUNSELING LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/CLINICIAN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SANDRINE |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | AEGERTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC, LMHC |
Authorized Official - Phone: | 617-935-2245 |
Mailing Address - Street 1: | 16420 N THOMPSON PEAK PKWY UNIT 1122 |
Mailing Address - Street 2: | |
Mailing Address - City: | SCOTTSDALE |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85260-2169 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 617-935-2245 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 16420 N THOMPSON PEAK PKWY UNIT 1122 |
Practice Address - Street 2: | |
Practice Address - City: | SCOTTSDALE |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85260-2169 |
Practice Address - Country: | US |
Practice Address - Phone: | 617-935-2245 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-04-23 |
Last Update Date: | 2020-04-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |