Provider Demographics
NPI:1689726499
Name:INNER PEACE COUNSELING, INC
Entity Type:Organization
Organization Name:INNER PEACE COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CDP
Authorized Official - Phone:360-748-7268
Mailing Address - Street 1:118 N MARKET BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-2666
Mailing Address - Country:US
Mailing Address - Phone:360-748-7268
Mailing Address - Fax:360-740-9787
Practice Address - Street 1:118 N MARKET BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-2666
Practice Address - Country:US
Practice Address - Phone:360-748-7268
Practice Address - Fax:360-740-9787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA21054900101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACP00005966OtherCHEMICAL DEPENDENCY PROFE