Provider Demographics
NPI:1316364607
Name:INNERGUIDANCE COUNSELING LLC
Entity Type:Organization
Organization Name:INNERGUIDANCE COUNSELING LLC
Other - Org Name:INNERGUIDANCE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EVE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HERZOG
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-868-8678
Mailing Address - Street 1:9501 DAKOTA RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1710
Mailing Address - Country:US
Mailing Address - Phone:612-868-8678
Mailing Address - Fax:
Practice Address - Street 1:9501 DAKOTA RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-1710
Practice Address - Country:US
Practice Address - Phone:612-868-8678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13741251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health