Healthcare Provider Details

I. General information

NPI: 1356206122
Provider Name (Legal Business Name): INSPIRE HEALING THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4481 SW NEW COURT
PORT ST LUCIE FL
34953
US

IV. Provider business mailing address

11582 SW VILLAGE PKWY
PORT ST LUCIE FL
34987-2392
US

V. Phone/Fax

Practice location:
  • Phone: 772-207-0994
  • Fax:
Mailing address:
  • Phone: 772-207-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name: SCHILLENA STEPHENS
Title or Position: OWNER
Credential: LMHC
Phone: 772-207-0994