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General NPI Number Information
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NPI Number | 1043172075
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Entity Type | Organization
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Legal Business Name | INNER PEACE AND WELLNESS, LLC
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Dates
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Enumeration Date | 11/28/2025
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 86 N THOMAS AVE
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City | KINGSTON
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State | PA
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Zip | 18704
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Country | US
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Telephone | 570-991-1368
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Fax |
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Provider Business Mailing Address
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Address Line | 453 ARENA HUB PLZ # 1013
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City | WILKES BARRE
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State | PA
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Zip | 18702-6839
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Country | US
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Telephone | 570-991-1368
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KIMBERLY COSLETT
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Credential | PMHNP-BC
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Telephone | 570-991-1368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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