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General NPI Number Information
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NPI Number | 1134938251
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Entity Type | Organization
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Legal Business Name | INTENTIONAL RELATIONSHIP THERAPY LLC
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 1950 E GREYHOUND PASS STE 18-108
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City | CARMEL
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State | IN
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Zip | 46033-7787
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Country | US
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Telephone | 224-408-0156
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 E GREYHOUND PASS STE 18-108
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City | CARMEL
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State | IN
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Zip | 46033-7787
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Country | US
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Telephone | 224-408-0156
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER/CEO
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Name | MRS. TAKISHA CARLA BROOKS
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Credential | LMFT
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Telephone | 224-408-0156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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