Provider Demographics
NPI:1083434096
Name:INNER PEACE COUNSELING OF TAMPA BAY LLC
Entity type:Organization
Organization Name:INNER PEACE COUNSELING OF TAMPA BAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:SAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:706-825-8424
Mailing Address - Street 1:6609 GATES POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-1318
Mailing Address - Country:US
Mailing Address - Phone:706-825-8424
Mailing Address - Fax:813-374-8820
Practice Address - Street 1:6609 GATES POINTE WAY
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-1318
Practice Address - Country:US
Practice Address - Phone:706-825-8424
Practice Address - Fax:813-374-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty