Healthcare Provider Details

I. General information

NPI: 1144817867
Provider Name (Legal Business Name): INSPIRING U THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 ALTO AVE SE
GRAND RAPIDS MI
49507-1403
US

IV. Provider business mailing address

1115 ALTO AVE SE
GRAND RAPIDS MI
49507-1403
US

V. Phone/Fax

Practice location:
  • Phone: 616-719-0120
  • Fax: 616-719-3221
Mailing address:
  • Phone: 616-719-0120
  • Fax: 616-719-3221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LISA R BAKER
Title or Position: THERAPIST/OWNER
Credential: LMSW
Phone: 616-719-0120