Provider Demographics
NPI:1639909393
Name:INNER PEACE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:INNER PEACE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHELENA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-807-8878
Mailing Address - Street 1:PO BOX 58424
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25358-0424
Mailing Address - Country:US
Mailing Address - Phone:304-807-8788
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:722 DAVERTON RD
Practice Address - Street 2:
Practice Address - City:S CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-2405
Practice Address - Country:US
Practice Address - Phone:304-807-8878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty