Provider Demographics
NPI:1184000317
Name:WITHINSIGHT PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:WITHINSIGHT PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-650-9144
Mailing Address - Street 1:9920 S RUAL ROAD
Mailing Address - Street 2:SUITE 108-31
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-4100
Mailing Address - Country:US
Mailing Address - Phone:480-650-9144
Mailing Address - Fax:480-264-2763
Practice Address - Street 1:3200 N DOBSON RD
Practice Address - Street 2:SUITE D3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-9601
Practice Address - Country:US
Practice Address - Phone:480-650-9144
Practice Address - Fax:480-264-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1939103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1689618266OtherTYPE 1 NPI NUMBER