Provider Demographics
NPI: | 1114513389 |
---|---|
Name: | INNER HEALING COUNSELING LLC |
Entity Type: | Organization |
Organization Name: | INNER HEALING COUNSELING LLC |
Other - Org Name: | INNER HEALING COUNSELING LLC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | THERAPIST |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | TRACY |
Authorized Official - Middle Name: | JORDAN |
Authorized Official - Last Name: | ADAMS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LH60686283 |
Authorized Official - Phone: | 206-708-2695 |
Mailing Address - Street 1: | 600 N 36TH ST STE 321 |
Mailing Address - Street 2: | |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98103-8698 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-708-2695 |
Mailing Address - Fax: | 833-370-0319 |
Practice Address - Street 1: | 600 N 36TH ST STE 321 |
Practice Address - Street 2: | |
Practice Address - City: | SEATTLE |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98103-8698 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-708-2695 |
Practice Address - Fax: | 833-370-0319 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-12-11 |
Last Update Date: | 2023-12-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |