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NPI Code Detail

MEDICARE: INNER REINS COUNSELING, LLC

MEDICARE: INNER REINS COUNSELING, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
21041C0700XClinical Social Worker
3101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366113011
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER REINS COUNSELING, LLC
Provider Business Mailing Address
First Line : 2812 SERENITY CIR S
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5053
Country : US
Telephone Number : 772-259-6668
Fax Number :
Provider Business Practice Location Address
First Line : 2812 SERENITY CIR S
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5053
Country : US
Telephone Number : 772-259-6668
Fax Number :
Authorized Official
Title or Position : OWNER
Name : VALERIE PULLEN
Credential : LCSW
Telephone Number : 772-259-6668
Provider Enumeration Date : 09/22/2021
Last Update Date : 01/10/2024

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