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General NPI Number Information
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NPI Number | 1790575892
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Entity Type | Organization
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Legal Business Name | INNER ANNEALING PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 7398 OLD SAUK RD
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City | MADISON
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State | WI
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Zip | 53717-1213
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Country | US
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Telephone | 608-212-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 7613 ELMWOOD AVE # 620083
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City | MIDDLETON
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State | WI
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Zip | 53562-3191
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Country | US
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Telephone | 608-212-4010
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | AMY MARGULIES
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Credential | MS, LPC, SAC
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Telephone | 608-212-4010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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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