Provider Demographics
NPI:1003447301
Name:INSIGHT-THERAPY AZ
Entity Type:Organization
Organization Name:INSIGHT-THERAPY AZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC#14074
Authorized Official - Phone:602-315-4068
Mailing Address - Street 1:1550 E THUNDERBIRD RD APT 1006
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5625
Mailing Address - Country:US
Mailing Address - Phone:602-315-4068
Mailing Address - Fax:602-675-2705
Practice Address - Street 1:4545 E SHEA BLVD STE 235
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6048
Practice Address - Country:US
Practice Address - Phone:602-315-4068
Practice Address - Fax:602-675-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health