Provider Demographics
NPI:1831898261
Name:INNERWORK COUNSELING AND CONSULTATION
Entity type:Organization
Organization Name:INNERWORK COUNSELING AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-590-7063
Mailing Address - Street 1:382 NE 191ST ST # 228268
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3899
Mailing Address - Country:US
Mailing Address - Phone:561-590-7063
Mailing Address - Fax:
Practice Address - Street 1:631 NE 10TH AVE APT 2
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-5002
Practice Address - Country:US
Practice Address - Phone:561-590-7063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)