Provider Demographics
NPI:1053178061
Name:INWARD HEALING PSYCHIATRY LLC
Entity type:Organization
Organization Name:INWARD HEALING PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC MENTAL HEALTH NP
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JACOX
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:715-284-6060
Mailing Address - Street 1:25 S 2ND ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54615-1712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:N8571 TIMBER LN
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-8109
Practice Address - Country:US
Practice Address - Phone:715-284-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty