MEDICARE: INNER HEALING COUNSELING AND MEDIATION PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1760348924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER HEALING COUNSELING AND MEDIATION PLLC

Provider Business Mailing Address
First Line	:	PO BOX 932
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-0024
Country	:	US
Telephone Number	:	808-620-5267
Fax Number	:

Provider Business Practice Location Address
First Line	:	5560 FM 1640 RD # 932
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-5424
Country	:	US
Telephone Number	:	808-620-5267
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GABRIELA ALEJANDRA GONZALEZ-GREEN
Credential	:	LPC
Telephone Number	:	808-620-5267

Provider Enumeration Date	:	01/01/2026
Last Update Date	:	01/02/2026

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