Provider Demographics
NPI:1497233647
Name:BEYOND THE CLOUDS COUNSELING LLC
Entity Type:Organization
Organization Name:BEYOND THE CLOUDS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:574-933-1201
Mailing Address - Street 1:10811 CARDINAL CIR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-7970
Mailing Address - Country:US
Mailing Address - Phone:574-933-1201
Mailing Address - Fax:574-968-7404
Practice Address - Street 1:505 COLONIAL CT
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1860
Practice Address - Country:US
Practice Address - Phone:574-933-1201
Practice Address - Fax:574-968-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005729A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326225004OtherINDIVIDUAL NPI