Provider Demographics
NPI:1609513407
Name:INSIGHT BEHAVIOR PARTNERSHIP, LLC
Entity Type:Organization
Organization Name:INSIGHT BEHAVIOR PARTNERSHIP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:ADDLESON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:720-507-5226
Mailing Address - Street 1:12331 E CORNELL AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3323
Mailing Address - Country:US
Mailing Address - Phone:720-507-5226
Mailing Address - Fax:
Practice Address - Street 1:12331 E CORNELL AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3323
Practice Address - Country:US
Practice Address - Phone:720-507-5226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000164692Medicaid
CO9000162551Medicaid