Healthcare Provider Details

I. General information

NPI: 1992667893
Provider Name (Legal Business Name): INNER SOLACE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2025
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 JASPER LN
WAUKESHA WI
53188-3100
US

IV. Provider business mailing address

PO BOX 471
WAUKESHA WI
53187-0471
US

V. Phone/Fax

Practice location:
  • Phone: 262-282-3627
  • Fax:
Mailing address:
  • Phone: 262-282-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HALEY LEMIRE
Title or Position: LPC
Credential:
Phone: 262-282-3627