Provider Demographics
NPI:1164919262
Name:ASPIRE TO INSPIRE BEHAVIORAL HEALTH AND ADDICTION SERVICES, LLC
Entity Type:Organization
Organization Name:ASPIRE TO INSPIRE BEHAVIORAL HEALTH AND ADDICTION SERVICES, LLC
Other - Org Name:INSPIRE CONSULTING & SUPERVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MIKA-LUDE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, AADC-S, NCC
Authorized Official - Phone:773-208-5022
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:CULLODEN
Mailing Address - State:WV
Mailing Address - Zip Code:25510-0172
Mailing Address - Country:US
Mailing Address - Phone:304-760-9945
Mailing Address - Fax:
Practice Address - Street 1:3847 TEAYS VALLEY RD STE B
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526
Practice Address - Country:US
Practice Address - Phone:304-760-9945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16-323101YA0400X
WV2276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty