Provider Demographics
NPI:1609132901
Name:INNER PEACE PSYCHOLOGICAL SERVICES AND INTEGRATIVE WELLNESS CENTER
Entity Type:Organization
Organization Name:INNER PEACE PSYCHOLOGICAL SERVICES AND INTEGRATIVE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER AND THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ALLYN
Authorized Official - Last Name:SCHAAL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,NCC
Authorized Official - Phone:814-450-1608
Mailing Address - Street 1:102 TOWERVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3595
Mailing Address - Country:US
Mailing Address - Phone:919-594-6510
Mailing Address - Fax:
Practice Address - Street 1:102 TOWERVIEW CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3595
Practice Address - Country:US
Practice Address - Phone:919-594-6510
Practice Address - Fax:919-666-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7877101YP2500X
NC2009-013962084P0800X
NC195204363LP0808X
NC50-02016363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty