| Inner Wellness Therapy Llc | |
|
180 Tices Ln Ste 104 East Brunswick NJ 08816-1345 | |
| (732) 598-6396 | |
| (732) 548-5859 |
| Full Name | Inner Wellness Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 180 Tices Ln Ste 104, East Brunswick, New Jersey |
| Authorized Official Name and Position | Jennifer Rerngsamai (PROVIDER/OWNER) |
| Authorized Official Contact | 7325986396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Wellness Therapy Llc 180 Sunset Ave Old Bridge NJ 08857-1255 Ph: (732) 598-6396 | Inner Wellness Therapy Llc 180 Tices Ln Ste 104 East Brunswick NJ 08816-1345 Ph: (732) 598-6396 |
| NPI Number | 1346877974 |
|---|---|
| Provider Enumeration Date | 03/24/2020 |
| Last Update Date | 03/30/2020 |
| Certification Date | 03/30/2020 |
| Medicare PECOS PAC ID | 2365871571 |
|---|---|
| Medicare Enrollment ID | O20200408003700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346877974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jennifer Rerngsamai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346513991 PECOS PAC ID: 9830354547 Enrollment ID: I20120703000129 |
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