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General NPI Number Information
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NPI Number | 1053900415
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Entity Type | Organization
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Legal Business Name | INNER PEACE & CLARITY PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 01/11/2021
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 16701 MELFORD BLVD STE 400
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City | BOWIE
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State | MD
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Zip | 20715-4411
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Country | US
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Telephone | 301-778-8391
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Fax |
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Provider Business Mailing Address
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Address Line | 3754 SILVER PARK CT
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City | SUITLAND
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State | MD
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Zip | 20746-3039
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Country | US
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Telephone | 301-778-8391
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Fax | 240-712-5681
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Authorized Official
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Title or Position | CEO, CLINICIAN
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Name | MS. CYNTHIA JONES
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Credential | LCPC
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Telephone | 301-778-8391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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