Provider Demographics
NPI:1134641855
Name:INNER RESOURCES THERAPY LLC
Entity Type:Organization
Organization Name:INNER RESOURCES THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DEXTER
Authorized Official - Last Name:MEACHEM
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:803-829-6485
Mailing Address - Street 1:1700 FIRST BAXTER XING
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8948
Mailing Address - Country:US
Mailing Address - Phone:803-829-6485
Mailing Address - Fax:
Practice Address - Street 1:1700 FIRST BAXTER XING
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8948
Practice Address - Country:US
Practice Address - Phone:803-829-6485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC87371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty