Provider Demographics
NPI:1356071765
Name:INSPIRED VISION COUNSELING LLC
Entity Type:Organization
Organization Name:INSPIRED VISION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MOBLEY-TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:912-667-8806
Mailing Address - Street 1:100 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5675
Mailing Address - Country:US
Mailing Address - Phone:912-667-8806
Mailing Address - Fax:
Practice Address - Street 1:135 GOSHEN ROAD EXT STE 112
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5568
Practice Address - Country:US
Practice Address - Phone:912-295-3365
Practice Address - Fax:912-205-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty