Provider Demographics
NPI:1912788605
Name:ASPIRE MENTAL HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:ASPIRE MENTAL HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:434-444-6842
Mailing Address - Street 1:365 CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522-4051
Mailing Address - Country:US
Mailing Address - Phone:434-444-6842
Mailing Address - Fax:
Practice Address - Street 1:791 COURT ST STE 2928
Practice Address - Street 2:
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522-5000
Practice Address - Country:US
Practice Address - Phone:434-444-6842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty