Inspire Change Therapeutic Services Pllc | |
30410 Highway 200 # 200r-3 Ponderay ID 83852-9601 | |
(208) 290-5285 | |
Not Available |
Full Name | Inspire Change Therapeutic Services Pllc |
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Speciality | Social Worker - Clinical |
Location | 30410 Highway 200 # 200r-3, Ponderay, Idaho |
Authorized Official Name and Position | Michaella A Hammersberg (OWNER) |
Authorized Official Contact | 2082905285 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Inspire Change Therapeutic Services Pllc 217 Cedar St # 318 Sandpoint ID 83864-1410 Ph: (208) 290-5285 | Inspire Change Therapeutic Services Pllc 30410 Highway 200 # 200r-3 Ponderay ID 83852-9601 Ph: (208) 290-5285 |
NPI Number | 1164217873 |
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Provider Enumeration Date | 04/12/2025 |
Last Update Date | 04/12/2025 |
Certification Date | 04/12/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164217873 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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