Healthcare Provider Details

I. General information

NPI: 1790353324
Provider Name (Legal Business Name): ENSPIRE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 12/21/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39111 6 MILE RD STE 106
LIVONIA MI
48152-3926
US

IV. Provider business mailing address

19860 POLLYANNA DR
LIVONIA MI
48152-1232
US

V. Phone/Fax

Practice location:
  • Phone: 734-743-1253
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KRISTY THILL
Title or Position: OWNER
Credential: LPC
Phone: 734-649-1469