Provider Demographics
NPI:1447502687
Name:INSPIRING CHANGE, LLC
Entity type:Organization
Organization Name:INSPIRING CHANGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:PILGER
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-665-7403
Mailing Address - Street 1:1625 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3216
Mailing Address - Country:US
Mailing Address - Phone:954-665-7403
Mailing Address - Fax:954-434-5584
Practice Address - Street 1:1625 N COMMERCE PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3216
Practice Address - Country:US
Practice Address - Phone:954-665-7403
Practice Address - Fax:954-434-5584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6317103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty