Provider Demographics
NPI:1225857832
Name:INNER PEACE COUNSELING & WELLNESS
Entity type:Organization
Organization Name:INNER PEACE COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:682-803-5757
Mailing Address - Street 1:106 AUSTIN AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-3381
Mailing Address - Country:US
Mailing Address - Phone:682-803-5757
Mailing Address - Fax:
Practice Address - Street 1:106 AUSTIN AVE STE 207
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-3381
Practice Address - Country:US
Practice Address - Phone:682-803-5757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health