Provider Demographics
NPI:1659254811
Name:INNER PEACE COUNSELING PLLC
Entity type:Organization
Organization Name:INNER PEACE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CARLYSS
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KURTTI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LPCC
Authorized Official - Phone:701-732-0067
Mailing Address - Street 1:8263 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:MYLO
Mailing Address - State:ND
Mailing Address - Zip Code:58353-9431
Mailing Address - Country:US
Mailing Address - Phone:701-550-0105
Mailing Address - Fax:
Practice Address - Street 1:8263 53RD AVE
Practice Address - Street 2:
Practice Address - City:MYLO
Practice Address - State:ND
Practice Address - Zip Code:58353-9431
Practice Address - Country:US
Practice Address - Phone:701-732-0067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty