MEDICARE: INSPIRATION AND HOPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0999	NC
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356581193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRATION AND HOPE

Provider Business Mailing Address
First Line	:	PO BOX 185
Second Line	:
City	:	PINEVILLE
State	:	NC
Zip	:	28134-0185
Country	:	US
Telephone Number	:	980-216-1135
Fax Number	:

Provider Business Practice Location Address
First Line	:	4935 ALBEMARLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-6617
Country	:	US
Telephone Number	:	980-216-1135
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, CLINICAL SERVICES
Name	:	MS. BALRIE PARKS
Credential	:	M.ED. QMHP
Telephone Number	:	980-216-1135

Provider Enumeration Date	:	03/05/2009
Last Update Date	:	07/18/2012

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Directions to “INSPIRATION AND HOPE ” Practice Location

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