Healthcare Provider Details

I. General information

NPI: 1619728573
Provider Name (Legal Business Name): INSPIRED 2 B U PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4377 BAYLOR ST
GREENSBORO NC
27455-2557
US

IV. Provider business mailing address

4377 BAYLOR ST
GREENSBORO NC
27455-2557
US

V. Phone/Fax

Practice location:
  • Phone: 336-264-5141
  • Fax:
Mailing address:
  • Phone: 336-264-5141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. LATOYA CHEVELLE WADDELL
Title or Position: OWNER
Credential: PHD, LCMHCS, CCS
Phone: 336-954-7345