NPIMap

Organization Active NPI

Inner Self Healing Center, LLC

  • Professional Counselor
  • Gaithersburg, MD
National Provider Identifier
1881313823
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
INNER SELF HEALING CENTER, LLC
Practice address
12 S Summit Ave Ste 100-A06
Gaithersburg, MD 20877-2089
Phone
(301) 424-1800
NPI assigned
Aug 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Miran DalleyNPI 1790404721
Title
Owner
Phone
(301) 818-8182

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)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

12 S Summit Ave Ste 100-A06
Gaithersburg, MD 20877-2089

Mailing address

12 S Summit Ave Ste 100-A6
Gaithersburg, MD 20877-2089
Phone (301) 818-8182

Other practice location 1

14052 Verona Ln Apt 1326
Centreville, VA 20120-6354
Phone (301) 818-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@innerselfhealing.center Direct

National Provider Directory

National Provider Directory

Locations

100 N Court St
Ste 213
Frederick, MD 21701

12 S Summit Ave
Ste 100A6
Gaithersburg, MD 20877
Phone (301) 818-6000

Practitioners & affiliated clinicians

Practitioners 2

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": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1881313823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 S SUMMIT AVE STE 100-A6",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772089",
            "telephone_number": "301-818-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S SUMMIT AVE STE 100-A06",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772089",
            "telephone_number": "301-424-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14052 Verona Ln Apt 1326",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "VA",
            "postal_code": "201206354",
            "country_code": "US",
            "telephone_number": "301-818-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNER SELF HEALING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "DALLEY",
        "authorized_official_first_name": "MIRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-818-8182"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@innerselfhealing.center",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N Court St Ste 213",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217015416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.