Healthcare Provider Details

I. General information

NPI: 1275473373
Provider Name (Legal Business Name): INSPIRE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 2ND AVE S STE 2001091
MINNEAPOLIS MN
55401-5500
US

IV. Provider business mailing address

330 2ND AVE S STE 2001091
MINNEAPOLIS MN
55401-5500
US

V. Phone/Fax

Practice location:
  • Phone: 734-747-0772
  • Fax:
Mailing address:
  • Phone: 734-747-0772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FAHMO HANS
Title or Position: MENTAL HEALTH PROFESSIONAL
Credential: LPCC
Phone: 734-747-0772