Healthcare Provider Details

I. General information

NPI: 1821534082
Provider Name (Legal Business Name): INSPIRED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7864 CAMARGO RD
CINCINNATI OH
45243-2652
US

IV. Provider business mailing address

7864 CAMARGO RD
CINCINNATI OH
45243-2652
US

V. Phone/Fax

Practice location:
  • Phone: 502-727-4193
  • Fax:
Mailing address:
  • Phone: 502-727-4193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberE1200550-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE1200550-SUPV
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE0500124-SUPV
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7023
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number7023
License Number StateOH

VIII. Authorized Official

Name: DR. NATALIE ANNE WINTERS
Title or Position: OWNER & LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 513-713-6614