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NPI 1558973560

NPI 1558973560 : INNER PEACE COUNSELING, LLC : GREENWOOD, IN

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General NPI Number Information
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    NPI Number           |    1558973560
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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     |    08/20/2020
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    Last Update Date     |    03/14/2021
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Provider Practice Location Address
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    Address Line         |    1130 LONDONERRY LN 
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    City                 |    GREENWOOD
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    State                |    IN
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    Zip                  |    46142-1632
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    Country              |    US
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    Telephone            |    812-568-5267
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1130 LONDONERRY LN 
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    City                 |    GREENWOOD
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    State                |    IN
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    Zip                  |    46142-1632
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    Country              |    US
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    Telephone            |    812-568-5267
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     CORY  BUCHANAN 
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    Credential           |    LCSW
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    Telephone            |    812-568-5267
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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       |    
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    License Number State |    
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