Provider Demographics
NPI:1194251140
Name:INSPIRING CHANGE PROFESSIONAL COUNSELING SERVICES
Entity type:Organization
Organization Name:INSPIRING CHANGE PROFESSIONAL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:MAURER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC/S
Authorized Official - Phone:864-724-7552
Mailing Address - Street 1:4120 CLEMSON BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1176
Mailing Address - Country:US
Mailing Address - Phone:864-724-7552
Mailing Address - Fax:
Practice Address - Street 1:4120 CLEMSON BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1176
Practice Address - Country:US
Practice Address - Phone:864-724-7552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5611101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty