Healthcare Provider Details

I. General information

NPI: 1134816143
Provider Name (Legal Business Name): INSPIRATIONAL THERAPY L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N CEDAR ST STE 110
POST FALLS ID
83854-6220
US

IV. Provider business mailing address

1201 LINCOLN WAY APT 107
COEUR D ALENE ID
83814-2384
US

V. Phone/Fax

Practice location:
  • Phone: 208-699-5673
  • Fax:
Mailing address:
  • Phone: 208-699-5673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. CARMEN RENEE JEFFREY
Title or Position: THERAPIST MENTAL HEALTH
Credential: LMSW
Phone: 208-618-3474