Provider Demographics
NPI:1386034718
Name:INSIGHT PROFESSIONAL COUNSELING LLC
Entity Type:Organization
Organization Name:INSIGHT PROFESSIONAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-267-4327
Mailing Address - Street 1:4 ALMONT ACRES
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1727
Mailing Address - Country:US
Mailing Address - Phone:314-267-4327
Mailing Address - Fax:
Practice Address - Street 1:408 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2824
Practice Address - Country:US
Practice Address - Phone:314-550-0830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007008532251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO494049109Medicaid