Provider Demographics
NPI:1861043606
Name:INNER HEALING LLC
Entity Type:Organization
Organization Name:INNER HEALING LLC
Other - Org Name:LIVE WELL HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-624-9699
Mailing Address - Street 1:124 S KEENELAND DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3279
Mailing Address - Country:US
Mailing Address - Phone:859-624-9699
Mailing Address - Fax:859-624-2699
Practice Address - Street 1:124 S KEENELAND DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3279
Practice Address - Country:US
Practice Address - Phone:859-624-9699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100372130Medicaid
KYK127500OtherMEDICARE PIN