Provider Demographics
NPI:1235910548
Name:INNER PEACE PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:INNER PEACE PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-421-9678
Mailing Address - Street 1:66 HALL ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-5274
Mailing Address - Country:US
Mailing Address - Phone:774-421-9678
Mailing Address - Fax:
Practice Address - Street 1:66 HALL ST APT 3
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5274
Practice Address - Country:US
Practice Address - Phone:774-421-9678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty