Provider Demographics
NPI:1689216616
Name:AWAKEN INSIGHT
Entity Type:Organization
Organization Name:AWAKEN INSIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER/MANAGER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:CARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:210-527-8755
Mailing Address - Street 1:2186 JACKSON KELLER RD
Mailing Address - Street 2:PMB 3081
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213
Mailing Address - Country:US
Mailing Address - Phone:210-527-8755
Mailing Address - Fax:210-714-9757
Practice Address - Street 1:11-3784 2ND ST
Practice Address - Street 2:
Practice Address - City:VOLCANO
Practice Address - State:HI
Practice Address - Zip Code:96785
Practice Address - Country:US
Practice Address - Phone:210-527-8755
Practice Address - Fax:210-714-9757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty