Healthcare Provider Details

I. General information

NPI: 1396620308
Provider Name (Legal Business Name): ASPIRE WELLNESS GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1183 EDDY ST
PROVIDENCE RI
02905-4510
US

IV. Provider business mailing address

1090 EDDY ST
PROVIDENCE RI
02905-4607
US

V. Phone/Fax

Practice location:
  • Phone: 401-640-7648
  • Fax: 401-223-6474
Mailing address:
  • Phone: 401-640-7648
  • Fax: 401-223-6474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERNY FRANCISCO
Title or Position: OWNER
Credential:
Phone: 401-640-7648