Provider Demographics
NPI:1134776206
Name:INNER WORLD COUNSELING & HEALING, LLC
Entity type:Organization
Organization Name:INNER WORLD COUNSELING & HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:303-330-7074
Mailing Address - Street 1:2609 DANFORTH TER
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3416
Mailing Address - Country:US
Mailing Address - Phone:303-330-7074
Mailing Address - Fax:
Practice Address - Street 1:2609 DANFORTH TER
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3416
Practice Address - Country:US
Practice Address - Phone:303-330-7074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1124686266OtherMENTAL HEALTH COUNSELOR