Provider Demographics
NPI:1679295158
Name:INNER INTELLIGENCE COUNSELING & CONSULTING SERVICES PLLC
Entity type:Organization
Organization Name:INNER INTELLIGENCE COUNSELING & CONSULTING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC LADC
Authorized Official - Phone:802-622-1229
Mailing Address - Street 1:PO BOX 78
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05670-0078
Mailing Address - Country:US
Mailing Address - Phone:802-622-1229
Mailing Address - Fax:
Practice Address - Street 1:132 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3226
Practice Address - Country:US
Practice Address - Phone:802-622-1229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty