Provider Demographics
NPI:1891393542
Name:INNER ESSENCE THERAPY, CONSULTING AND DIAGNOSTIC PLLC
Entity Type:Organization
Organization Name:INNER ESSENCE THERAPY, CONSULTING AND DIAGNOSTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHERY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-686-3446
Mailing Address - Street 1:10800 GOSLING RD UNIT 130142
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-4008
Mailing Address - Country:US
Mailing Address - Phone:510-686-3446
Mailing Address - Fax:832-202-1360
Practice Address - Street 1:10800 GOSLING RD UNIT 130142
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77393-4008
Practice Address - Country:US
Practice Address - Phone:510-686-3446
Practice Address - Fax:832-202-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)