Provider Demographics
NPI:1760837207
Name:INNER NOURISH COUNSELING
Entity Type:Organization
Organization Name:INNER NOURISH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:813-785-9742
Mailing Address - Street 1:9758 LAREDO ST
Mailing Address - Street 2:8C
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9803
Mailing Address - Country:US
Mailing Address - Phone:813-785-9742
Mailing Address - Fax:
Practice Address - Street 1:9758 LAREDO ST
Practice Address - Street 2:8C
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9803
Practice Address - Country:US
Practice Address - Phone:813-785-9742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012939101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty