Healthcare Provider Details

I. General information

NPI: 1043121866
Provider Name (Legal Business Name): INNER SYSTEMS THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1543 W 110 N
PLEASANT GROVE UT
84062-3555
US

IV. Provider business mailing address

1543 W 110 N
PLEASANT GROVE UT
84062-3555
US

V. Phone/Fax

Practice location:
  • Phone: 801-592-9525
  • Fax:
Mailing address:
  • Phone: 801-592-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LISA MICHELLE RINCON
Title or Position: OWNER
Credential: CMHC
Phone: 801-592-9525