Provider Demographics
NPI:1477969210
Name:INSPIRE BEHAVIORAL THERAPY
Entity Type:Organization
Organization Name:INSPIRE BEHAVIORAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVERNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:779-279-9481
Mailing Address - Street 1:2321 PEREGRINE DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3615
Mailing Address - Country:US
Mailing Address - Phone:779-279-9481
Mailing Address - Fax:
Practice Address - Street 1:2321 PEREGRINE DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-3615
Practice Address - Country:US
Practice Address - Phone:779-279-9481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty