Provider Demographics
NPI:1790121275
Name:INSIGHT COUNSELING
Entity Type:Organization
Organization Name:INSIGHT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:DENICE
Authorized Official - Last Name:WEE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-710-0812
Mailing Address - Street 1:11024 MONTGOMERY BLVD NE
Mailing Address - Street 2:PMB# 148
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3962
Mailing Address - Country:US
Mailing Address - Phone:505-710-0812
Mailing Address - Fax:
Practice Address - Street 1:10512 GUADALAJARA AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1719
Practice Address - Country:US
Practice Address - Phone:505-710-0812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0111751101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM59572833Medicaid