| Inspired Wellness, Llc | |
|
7511 Saint Andrews Rd Ste 4 Irmo SC 29063-2894 | |
| (803) 575-0579 | |
| (803) 830-3873 |
| Full Name | Inspired Wellness, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7511 Saint Andrews Rd Ste 4, Irmo, South Carolina |
| Authorized Official Name and Position | Angela Jackson (OWNER) |
| Authorized Official Contact | 8035424152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inspired Wellness, Llc 501 Everton Dr Chapin SC 29036-7124 Ph: (803) 542-4152 | Inspired Wellness, Llc 7511 Saint Andrews Rd Ste 4 Irmo SC 29063-2894 Ph: (803) 575-0579 |
| NPI Number | 1528644713 |
|---|---|
| Provider Enumeration Date | 03/19/2021 |
| Last Update Date | 03/24/2021 |
| Certification Date | 03/24/2021 |
| Medicare PECOS PAC ID | 7810305208 |
|---|---|
| Medicare Enrollment ID | O20210423002030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528644713 | NPI | - | NPPES |
| SW1739 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922511419 PECOS PAC ID: 0840603346 Enrollment ID: I20201230000290 |
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