| Inspiring Change Pllc | |
|
1830 Owen Dr Ste 103 Fayetteville NC 28304-3412 | |
| (910) 273-1393 | |
| (910) 764-6756 |
| Full Name | Inspiring Change Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1830 Owen Dr Ste 103, Fayetteville, North Carolina |
| Authorized Official Name and Position | Juanita Harding (CO-OWNER) |
| Authorized Official Contact | 9102731393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inspiring Change Pllc 1930 Tar Heel Rd Lumberton NC 28358-8752 Ph: (910) 273-1393 | Inspiring Change Pllc 1830 Owen Dr Ste 103 Fayetteville NC 28304-3412 Ph: (910) 273-1393 |
| NPI Number | 1982251104 |
|---|---|
| Provider Enumeration Date | 08/22/2019 |
| Last Update Date | 06/08/2021 |
| Certification Date | 06/08/2021 |
| Medicare PECOS PAC ID | 0244630713 |
|---|---|
| Medicare Enrollment ID | O20210621002880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982251104 | NPI | - | NPPES |
| Provider Name | Stephen David Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720322688 PECOS PAC ID: 5991082679 Enrollment ID: I20170505001466 |
| Provider Name | Juanita Massol |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659664324 PECOS PAC ID: 5698030203 Enrollment ID: I20180601001005 |
| Provider Name | Telisa Pharris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871944124 PECOS PAC ID: 4082964069 Enrollment ID: I20180912003457 |
| Provider Name | Stephanie Moore Anderton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538832050 PECOS PAC ID: 2466891122 Enrollment ID: I20240415003474 |
| Provider Name | Francesca Esdaile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750929360 PECOS PAC ID: 1052750395 Enrollment ID: I20240418002999 |
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