Provider Demographics
NPI:1417608407
Name:INSIGHTFUL BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:INSIGHTFUL BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:III
Authorized Official - Credentials:LCSW
Authorized Official - Phone:573-915-2251
Mailing Address - Street 1:1910 GREENWOOD DR STE A
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-2428
Mailing Address - Country:US
Mailing Address - Phone:573-840-0615
Mailing Address - Fax:
Practice Address - Street 1:1600 W MAUD STREET
Practice Address - Street 2:STE 2
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-2428
Practice Address - Country:US
Practice Address - Phone:573-840-0615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty