Provider Demographics
NPI:1548733967
Name:NEW INSIGHT INTEGRATED HEALTH SERVICES
Entity Type:Organization
Organization Name:NEW INSIGHT INTEGRATED HEALTH SERVICES
Other - Org Name:NEW INSIGHT HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEIRDRE
Authorized Official - Middle Name:CROCHEN
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-381-4445
Mailing Address - Street 1:813 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35064-1545
Mailing Address - Country:US
Mailing Address - Phone:205-215-3980
Mailing Address - Fax:
Practice Address - Street 1:7300 1ST AVE N STE A
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35206-4213
Practice Address - Country:US
Practice Address - Phone:205-215-3980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3708OtherLPC LICENSE