Provider Demographics
NPI:1760182356
Name:INSIGHTFUL GROWTH THERAPY INC
Entity Type:Organization
Organization Name:INSIGHTFUL GROWTH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:NAZIR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-509-7730
Mailing Address - Street 1:210 S ELLSWORTH AVENUE
Mailing Address - Street 2:#268
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-9991
Mailing Address - Country:US
Mailing Address - Phone:415-509-7730
Mailing Address - Fax:
Practice Address - Street 1:100 S SAN MATEO DR
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401
Practice Address - Country:US
Practice Address - Phone:415-509-7730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty