MEDICARE: INNER LIGHT THERAPY

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	:	1619765997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER LIGHT THERAPY

Provider Business Mailing Address
First Line	:	378 SUNNY ACRES DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45255-3906
Country	:	US
Telephone Number	:	513-512-4215
Fax Number	:

Provider Business Practice Location Address
First Line	:	7733 BEECHMONT AVE STE 175
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45255-4237
Country	:	US
Telephone Number	:	513-512-4215
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA FRYE
Credential	:
Telephone Number	:	513-512-4215

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	04/28/2025

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Directions to “INNER LIGHT THERAPY ” Practice Location

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