# INNER BALANCE PSYCHOTHERAPY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376390880
- **Authorized official:** MARISA SISSEL (PROVIDER/OWNER)
- **Authorized official phone:** (785) 236-9196

## Contact information

- **Practice address:** 208 E 2ND NORTH ST, SUMMERVILLE, SC 29483-2157
- **Practice address phone:** (785) 236-9196
- **Mailing address:** 208 E 2ND NORTH ST, SUMMERVILLE, SC 29483-2157

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2024
- **Last updated:** 05/02/2024