Provider Demographics
NPI:1023879822
Name:INSIDE EMOTIONS THERAPY LLC
Entity type:Organization
Organization Name:INSIDE EMOTIONS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LPCC
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ODDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:612-816-9462
Mailing Address - Street 1:3803 SILVER LAKE RD NE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT ANTHONY
Mailing Address - State:MN
Mailing Address - Zip Code:55421-4575
Mailing Address - Country:US
Mailing Address - Phone:612-712-1993
Mailing Address - Fax:
Practice Address - Street 1:3803 SILVER LAKE RD NE STE 100
Practice Address - Street 2:
Practice Address - City:SAINT ANTHONY
Practice Address - State:MN
Practice Address - Zip Code:55421-4575
Practice Address - Country:US
Practice Address - Phone:612-712-1993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)