Provider Demographics
NPI:1578000998
Name:INSIGHT CENTER FOR CREATIVE COUNSELING, LLC
Entity Type:Organization
Organization Name:INSIGHT CENTER FOR CREATIVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:S
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LCSW
Authorized Official - Phone:734-489-3043
Mailing Address - Street 1:25602 W 12 MILE RD
Mailing Address - Street 2:APT. 103
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-8039
Mailing Address - Country:US
Mailing Address - Phone:734-489-3043
Mailing Address - Fax:
Practice Address - Street 1:17340 W 12 MILE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2122
Practice Address - Country:US
Practice Address - Phone:734-489-3043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty