Provider Demographics
NPI:1407227853
Name:INSIGHT COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:INSIGHT COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ACS, LPC
Authorized Official - Phone:908-612-3350
Mailing Address - Street 1:1 HIGHGROVE CT
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-3814
Mailing Address - Country:US
Mailing Address - Phone:908-612-3350
Mailing Address - Fax:
Practice Address - Street 1:1 HIGHGROVE CT
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-3814
Practice Address - Country:US
Practice Address - Phone:908-612-3350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLPC37PC00089300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ474699626/000Medicaid