Healthcare Provider Details

I. General information

NPI: 1790463271
Provider Name (Legal Business Name): BE INSPIRED COUNSELING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 BARTON BLVD STE 8
ROCKLEDGE FL
32955-3143
US

IV. Provider business mailing address

PO BOX 237612
COCOA FL
32923-7612
US

V. Phone/Fax

Practice location:
  • Phone: 321-301-0180
  • Fax:
Mailing address:
  • Phone: 321-301-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ROSA IRENA FOOTMAN
Title or Position: OWNER/CEO
Credential: LMFT
Phone: 321-301-0180