Provider Demographics
NPI:1831917343
Name:INNER HARMONY PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:INNER HARMONY PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:VISALLI-BETTAG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:260-249-7505
Mailing Address - Street 1:806 NW 16TH AVE UNIT 172
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3600 NW 43RD ST STE E2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-8134
Practice Address - Country:US
Practice Address - Phone:352-448-8531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty