| Innerworks Therapy Services Pllc | |
|
12377 91st Avenue North Seminole FL 33772 | |
| (563) 508-2268 | |
| Not Available |
| Full Name | Innerworks Therapy Services Pllc |
|---|---|
| Speciality | Counselor |
| Location | 12377 91st Avenue North, Seminole, Florida |
| Authorized Official Name and Position | Kristen Hull-houghton (OWNER) |
| Authorized Official Contact | 5635082268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innerworks Therapy Services Pllc 12377 91st Avenue North Seminole FL 33772 Ph: (563) 508-2268 | Innerworks Therapy Services Pllc 12377 91st Avenue North Seminole FL 33772 Ph: (563) 508-2268 |
| NPI Number | 1518692318 |
|---|---|
| Provider Enumeration Date | 07/18/2022 |
| Last Update Date | 03/01/2024 |
| Certification Date | 03/01/2024 |
| Medicare PECOS PAC ID | 8628415585 |
|---|---|
| Medicare Enrollment ID | O20240327001918 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518692318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kristen Hull-houghton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538544747 PECOS PAC ID: 9537506498 Enrollment ID: I20240327002014 |
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