Provider Demographics
NPI:1689910804
Name:INSPIRE COUNSELING AND WELLNESS
Entity Type:Organization
Organization Name:INSPIRE COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:309-453-3604
Mailing Address - Street 1:6707 N SHERIDAN RD STE N
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-2848
Mailing Address - Country:US
Mailing Address - Phone:309-648-1553
Mailing Address - Fax:309-691-7383
Practice Address - Street 1:6707 N SHERIDAN RD STE N
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2848
Practice Address - Country:US
Practice Address - Phone:309-648-1553
Practice Address - Fax:309-691-7383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
180.007832101YP2500X
IL149.015362251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty