=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467249755
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INSPIRED 2 EMPOWER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/22/2025
-----------------------------------------------------
Last Update Date | 04/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5505 S PEORIA AVE
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74105-6821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-509-5466
-----------------------------------------------------
Fax | 423-509-0173
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2134 ASHFORD VILLA CIR
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37421-5093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-509-5466
-----------------------------------------------------
Fax | 423-509-0173
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST
-----------------------------------------------------
Name | LATRICIA TAYLOR
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 405-509-5466
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------