Inner Peace Pensacola LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INNER PEACE PENSACOLA LLC

Practice address

600 University Office Blvd Ste 7
Pensacola, FL 32504-6251

Phone

(850) 292-4032

NPI assigned

Apr 15, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacob Price

Title

Owner

Phone

(850) 292-4032

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1831752039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY OFFICE BLVD STE 7",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY OFFICE BLVD STE 7",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046251",
            "telephone_number": "850-292-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER PEACE PENSACOLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-292-4032"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC LICENSE",
            "identifier": "MH13948",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.