Provider Demographics
NPI:1346099553
Name:INNER KNOWING THERAPY LLC
Entity type:Organization
Organization Name:INNER KNOWING THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-314-9334
Mailing Address - Street 1:4525 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3541
Mailing Address - Country:US
Mailing Address - Phone:612-314-9334
Mailing Address - Fax:612-520-5866
Practice Address - Street 1:8170 OLD CARRIAGE CT STE 200
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3169
Practice Address - Country:US
Practice Address - Phone:612-314-9334
Practice Address - Fax:612-520-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-18
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health