Provider Demographics
NPI:1932880655
Name:INNER PEACE COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:INNER PEACE COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOGERST
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:920-252-2297
Mailing Address - Street 1:541 HIGHLANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-3817
Mailing Address - Country:US
Mailing Address - Phone:920-252-2297
Mailing Address - Fax:
Practice Address - Street 1:530 WALNUT ST STE 2
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-3331
Practice Address - Country:US
Practice Address - Phone:920-252-2297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)