MEDICARE: INNER VIEW THERAPY INC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1619733953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER VIEW THERAPY INC

Provider Business Mailing Address
First Line	:	25435 W ROUTE 30
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-9781
Country	:	US
Telephone Number	:	630-392-1397
Fax Number	:

Provider Business Practice Location Address
First Line	:	25435 W ROUTE 30
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-9781
Country	:	US
Telephone Number	:	630-392-1397
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	ANDREA HOLM
Credential	:	LCPC
Telephone Number	:	630-392-1397

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	02/23/2024

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Directions to “INNER VIEW THERAPY INC ” Practice Location

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