Provider Demographics
NPI:1679340483
Name:INSPIRED GROWTH THERAPY PLLC
Entity Type:Organization
Organization Name:INSPIRED GROWTH THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LEMAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-234-2428
Mailing Address - Street 1:1831 W WARNER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1862
Mailing Address - Country:US
Mailing Address - Phone:574-514-2347
Mailing Address - Fax:
Practice Address - Street 1:4043 N RAVENSWOOD AVE STE 309-6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1155
Practice Address - Country:US
Practice Address - Phone:773-234-2428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health