Provider Demographics
NPI:1487998290
Name:INSPIRATION FAMILY COUNSELING, LLC
Entity type:Organization
Organization Name:INSPIRATION FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKWUMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MHP (U/S)
Authorized Official - Phone:405-315-1357
Mailing Address - Street 1:4513B SE 29TH ST
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-3315
Mailing Address - Country:US
Mailing Address - Phone:405-315-1357
Mailing Address - Fax:
Practice Address - Street 1:3816 N MERIDIAN AVE
Practice Address - Street 2:STE 113
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2852
Practice Address - Country:US
Practice Address - Phone:405-315-1357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health