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General NPI Number Information
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NPI Number | 1871142869
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Entity Type | Organization
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Legal Business Name | ASPIRE INTEGRATED HEALTH, PLLC
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 4114 N WATER TOWER PL STE F
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City | MOUNT VERNON
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State | IL
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Zip | 62864-6548
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Country | US
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Telephone | 618-634-7753
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Fax | 618-216-1492
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Provider Business Mailing Address
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Address Line | 4114 N WATER TOWER PL STE F
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City | MOUNT VERNON
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State | IL
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Zip | 62864-6548
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Country | US
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Telephone | 618-634-7753
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Fax | 618-216-1492
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | AMBER PHELPS SCHWEDA
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Credential | LCPC
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Telephone | 618-634-7753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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