=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124979844
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INNER PEACE COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2026
-----------------------------------------------------
Last Update Date | 02/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2425 MEDINA RD STE 112
-----------------------------------------------------
City | MEDINA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44256-5394
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-527-5731
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2425 MEDINA RD STE 112
-----------------------------------------------------
City | MEDINA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44256-5394
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-527-5731
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/COUNSELOR
-----------------------------------------------------
Name | MICHELLE KOEWLER
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 216-527-5731
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------