Active NPI
Inner Peace Therapy LLC
- Clinical Social Worker
- Lafayette, IN
National Provider Identifier
1154092369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- INNER PEACE THERAPY LLC
- Practice address
- 420 Main St
Lafayette, IN 47901-1326 - Phone
- (765) 202-2574
- NPI assigned
- Sep 27, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephanie Milan
- Title
- Owner
- Phone
- (765) 388-9560
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
420 Main St
Lafayette, IN 47901-1326
Mailing address
PO Box 566
Delphi, IN 46923-0566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211118000984 | IN | Part B Supplier - Clinic/Group Practice | 4183013857 |
Receives reassigned benefits from 1 practitioner Practice locations: Delphi, IN |
National Provider Directory
National Provider DirectoryLocations
420 Main St
Lafayette, IN 47901
Phone (765) 202-2574
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632700800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661904000000",
"number": "1154092369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 566",
"city": "DELPHI",
"state": "IN",
"postal_code": "469230566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 MAIN ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479011326",
"telephone_number": "765-202-2574"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INNER PEACE THERAPY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-27",
"last_updated": "2022-08-31",
"certification_date": "2022-08-31",
"status": "A",
"authorized_official_last_name": "MILAN",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "765-388-9560"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.