MEDICARE: INNER ALCHEMY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1003315797	OTHER	MD	NPI

General Provider Information

NPI Number	:	1477154482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER ALCHEMY LLC

Provider Business Mailing Address
First Line	:	629 S STREEPER ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-3831
Country	:	US
Telephone Number	:	703-371-8581
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 S STREEPER ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-3831
Country	:	US
Telephone Number	:	443-330-2769
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RACHEL SHEFFEL
Credential	:	LCPC
Telephone Number	:	703-371-8581

Provider Enumeration Date	:	11/05/2020
Last Update Date	:	11/05/2020

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Directions to “INNER ALCHEMY LLC ” Practice Location

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