Provider Demographics
NPI:1235605171
Name:INSPIRE BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:INSPIRE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:OTT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:267-563-8180
Mailing Address - Street 1:36 FAIRWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN SHORES
Mailing Address - State:NC
Mailing Address - Zip Code:27949
Mailing Address - Country:US
Mailing Address - Phone:215-817-5055
Mailing Address - Fax:484-848-5195
Practice Address - Street 1:1288 VALLEY FORGE RD
Practice Address - Street 2:UNIT 54
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460
Practice Address - Country:US
Practice Address - Phone:267-563-8180
Practice Address - Fax:484-848-5195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty