Healthcare Provider Details

I. General information

NPI: 1881507697
Provider Name (Legal Business Name): INNERVENTURE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5699 N CENTERPARK WAY APT 544
GLENDALE WI
53217-4576
US

IV. Provider business mailing address

5699 N CENTERPARK WAY APT 544
GLENDALE WI
53217-4576
US

V. Phone/Fax

Practice location:
  • Phone: 414-415-0999
  • Fax: 213-573-0873
Mailing address:
  • Phone: 414-415-0999
  • Fax: 213-573-0873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL F SMITH
Title or Position: FOUNDER
Credential: LPC
Phone: 414-415-0999