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General NPI Number Information
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NPI Number | 1134727274
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Entity Type | Organization
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Legal Business Name | INNER PEACE COUNSELING & WELLNESS
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 03/06/2021
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Provider Practice Location Address
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Address Line | 334 E LAKE RD DEPT 280
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City | PALM HARBOR
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State | FL
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Zip | 34685-2427
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Country | US
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Telephone | 888-732-2313
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Fax | 561-559-4005
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Provider Business Mailing Address
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Address Line | 334 E LAKE RD DEPT 280
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City | PALM HARBOR
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State | FL
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Zip | 34685-2427
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Country | US
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Telephone | 888-732-2313
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Fax | 727-274-1714
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Authorized Official
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Title or Position | CEO, DIRECTOR
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Name | MR. TYLER M BONWIT
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Credential |
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Telephone | 888-732-2313
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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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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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