Provider Demographics
NPI:1437621240
Name:INNERZENSION THERAPY LLC
Entity Type:Organization
Organization Name:INNERZENSION THERAPY LLC
Other - Org Name:INNERZENSION THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/D&A/TA, AADC
Authorized Official - Phone:479-202-6290
Mailing Address - Street 1:803 CHANCERY LN
Mailing Address - Street 2:
Mailing Address - City:CAVE SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72718-9034
Mailing Address - Country:US
Mailing Address - Phone:479-202-6292
Mailing Address - Fax:479-335-1325
Practice Address - Street 1:101 PARKWOOD ST STE F
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8808
Practice Address - Country:US
Practice Address - Phone:479-202-6292
Practice Address - Fax:479-335-1325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty