Provider Demographics
NPI:1467669697
Name:INSELL, CHRISTOPHER BRUCE (LAC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRUCE
Last Name:INSELL
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MEGHAN LN
Mailing Address - Street 2:
Mailing Address - City:JUDSONIA
Mailing Address - State:AR
Mailing Address - Zip Code:72081-9302
Mailing Address - Country:US
Mailing Address - Phone:501-729-4479
Mailing Address - Fax:501-729-3537
Practice Address - Street 1:2040 FITZHUGH ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7409
Practice Address - Country:US
Practice Address - Phone:870-793-3334
Practice Address - Fax:870-793-3474
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ARA1201002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA1201002OtherLAC