Provider Demographics
NPI:1417581737
Name:ASPIRE CLINICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ASPIRE CLINICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-546-5202
Mailing Address - Street 1:24755 S RIVER TRL
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-8631
Mailing Address - Country:US
Mailing Address - Phone:815-546-5202
Mailing Address - Fax:
Practice Address - Street 1:24014 W RENWICK RD UNIT 100
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-8710
Practice Address - Country:US
Practice Address - Phone:815-546-5202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty