Provider Demographics
NPI:1366953267
Name:INNER INSIGHT COUNSELING LLC
Entity type:Organization
Organization Name:INNER INSIGHT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:HESCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC INTERN, NCC
Authorized Official - Phone:503-313-7219
Mailing Address - Street 1:6700 SW 105TH AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-8824
Mailing Address - Country:US
Mailing Address - Phone:503-313-7219
Mailing Address - Fax:
Practice Address - Street 1:6700 SW 105TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-8824
Practice Address - Country:US
Practice Address - Phone:503-313-7219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health