Healthcare Provider Details

I. General information

NPI: 1588593701
Provider Name (Legal Business Name): INNER WORLDS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 S MAIN ST
VIROQUA WI
54665-3000
US

IV. Provider business mailing address

200 E VERONA AVE # 1108
VERONA WI
53593-1223
US

V. Phone/Fax

Practice location:
  • Phone: 319-610-6686
  • Fax:
Mailing address:
  • Phone: 319-610-6686
  • 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: HEIDI MCKINLEY
Title or Position: OWNER
Credential: LPC
Phone: 319-610-6686