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General NPI Number Information
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NPI Number | 1114523156
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Entity Type | Organization
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Legal Business Name | UPLIFT & INSPIRE,LLC
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Dates
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Enumeration Date | 12/06/2020
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 6035 EXECUTIVE DR STE 204
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City | LANSING
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State | MI
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Zip | 48911-5338
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Country | US
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Telephone | 734-627-7669
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Fax | 734-627-6001
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Provider Business Mailing Address
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Address Line | 6035 EXECUTIVE DR STE 204
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City | LANSING
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State | MI
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Zip | 48911-5338
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Country | US
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Telephone | 734-627-7669
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. DOMONIKA TIPTON
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Credential | LMSW
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Telephone | 734-627-7669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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