Provider Demographics
NPI:1245852433
Name:INNER ANCHOR, LLC
Entity type:Organization
Organization Name:INNER ANCHOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:276-233-0478
Mailing Address - Street 1:68 BROOK STONE CT APT 18
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-4285
Mailing Address - Country:US
Mailing Address - Phone:276-233-0478
Mailing Address - Fax:
Practice Address - Street 1:68 BROOK STONE CT APT 18
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-4285
Practice Address - Country:US
Practice Address - Phone:276-233-0478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health