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General NPI Number Information
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NPI Number | 1366706095
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Entity Type | Organization
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Legal Business Name | INNER PEACE COUNSELING, LLC
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 28105 THREE NOTCH RD
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City | MECHANICSVILLE
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State | MD
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Zip | 20659-3235
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Country | US
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Telephone | 240-538-3544
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Fax |
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Provider Business Mailing Address
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Address Line | 21991 PHILIP DR
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City | LEONARDTOWN
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State | MD
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Zip | 20650-2212
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Country | US
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Telephone | 240-538-3544
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. APRIL M KRIZ
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Credential | LCPC
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Telephone | 240-538-3544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LC4507
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License Number State | MD
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