Provider Demographics
NPI:1700305992
Name:INNERSTRENGTH THERAPY SERVICES
Entity Type:Organization
Organization Name:INNERSTRENGTH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:VERBOUT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, CST
Authorized Official - Phone:612-229-9790
Mailing Address - Street 1:10110 31ST AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-3170
Mailing Address - Country:US
Mailing Address - Phone:612-703-5401
Mailing Address - Fax:888-965-7702
Practice Address - Street 1:5821 CEDAR LAKE RD S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1487
Practice Address - Country:US
Practice Address - Phone:612-229-9790
Practice Address - Fax:888-965-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2043106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty