Provider Demographics
NPI:1568944494
Name:INSPIRATIONAL INSIGHT COUNSELING
Entity Type:Organization
Organization Name:INSPIRATIONAL INSIGHT COUNSELING
Other - Org Name:INSPIRATIONAL INSIGHT COUNSELING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FONDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MAUPIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-350-0196
Mailing Address - Street 1:PO BOX 2818
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654-2818
Mailing Address - Country:US
Mailing Address - Phone:870-501-7101
Mailing Address - Fax:
Practice Address - Street 1:706 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4458
Practice Address - Country:US
Practice Address - Phone:870-501-7101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1203028101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty