Provider Demographics
NPI:1619728573
Name:INSPIRED 2 B U PLLC
Entity Type:Organization
Organization Name:INSPIRED 2 B U PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:CHEVELLE
Authorized Official - Last Name:WADDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCMHCS, CCS
Authorized Official - Phone:336-954-7345
Mailing Address - Street 1:5710 YACHTSMAN CT
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9090
Mailing Address - Country:US
Mailing Address - Phone:336-954-7345
Mailing Address - Fax:
Practice Address - Street 1:5710 YACHTSMAN CT
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9090
Practice Address - Country:US
Practice Address - Phone:336-954-7345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1679817597OtherPROVIDER