Provider Demographics
NPI:1316584428
Name:INSIGHT THERAPY SAN DIEGO, A PROFESSIONAL MARRIAGE & FAMILY THERAPY CO
Entity Type:Organization
Organization Name:INSIGHT THERAPY SAN DIEGO, A PROFESSIONAL MARRIAGE & FAMILY THERAPY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SWISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-792-0308
Mailing Address - Street 1:11883 SPRUCE RUN DR APT C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-4756
Mailing Address - Country:US
Mailing Address - Phone:619-792-0308
Mailing Address - Fax:
Practice Address - Street 1:12636 HIGH BLUFF DR STE 400
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2071
Practice Address - Country:US
Practice Address - Phone:619-792-0308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty