Healthcare Provider Details

I. General information

NPI: 1952005167
Provider Name (Legal Business Name): INSPIRE BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 MAIN ST
GAITHERSBURG MD
20878-5543
US

IV. Provider business mailing address

232 MAIN ST
GAITHERSBURG MD
20878-5543
US

V. Phone/Fax

Practice location:
  • Phone: 240-912-4894
  • Fax:
Mailing address:
  • Phone: 240-912-4894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY HEBRON
Title or Position: OWNER
Credential:
Phone: 240-912-4894