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General NPI Number Information
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NPI Number | 1811367667
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Entity Type | Organization
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Legal Business Name | INSPIRE WELLNESS COUNSELING, PLLC
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 1919 STEARNS AVE
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City | KALAMAZOO
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State | MI
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Zip | 49008
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Country | US
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Telephone | 269-224-1545
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Fax | 269-312-8972
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Provider Business Mailing Address
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Address Line | 1919 STEARNS AVE
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City | KALAMAZOO
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State | MI
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Zip | 49008
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Country | US
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Telephone | 269-224-1545
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Fax | 269-312-8972
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | WILLIAM WARREN FITZGERALD
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Credential | PHD
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Telephone | 269-224-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6301015983
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License Number State | MI
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