Provider Demographics
NPI:1316783087
Name:IRIS INNOVATIONAL COUNSELING , LLC
Entity type:Organization
Organization Name:IRIS INNOVATIONAL COUNSELING , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCHEMILEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-596-9015
Mailing Address - Street 1:11024 LEGACY DR APT 204
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3631
Mailing Address - Country:US
Mailing Address - Phone:561-596-9015
Mailing Address - Fax:
Practice Address - Street 1:11024 LEGACY DR APT 204
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3631
Practice Address - Country:US
Practice Address - Phone:561-596-9015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty