Provider Demographics
NPI:1053195727
Name:INSPIRED PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:INSPIRED PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNYON
Authorized Official - Suffix:
Authorized Official - Credentials:LPP
Authorized Official - Phone:502-797-2503
Mailing Address - Street 1:7112 APPLE ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8023
Mailing Address - Country:US
Mailing Address - Phone:502-797-2503
Mailing Address - Fax:
Practice Address - Street 1:7112 APPLE ORCHARD LN
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-8023
Practice Address - Country:US
Practice Address - Phone:502-797-2503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty