Provider Demographics
NPI:1831641216
Name:INNER QUIET, LLC
Entity type:Organization
Organization Name:INNER QUIET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-504-3465
Mailing Address - Street 1:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33568-0684
Mailing Address - Country:US
Mailing Address - Phone:813-504-3465
Mailing Address - Fax:
Practice Address - Street 1:419 W PLATT ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2243
Practice Address - Country:US
Practice Address - Phone:813-244-1251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH14180OtherPRIVATE INSURANCE