Provider Demographics
NPI:1205290871
Name:NEUROSCIENTIFIC INSIGHTS
Entity type:Organization
Organization Name:NEUROSCIENTIFIC INSIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-468-1001
Mailing Address - Street 1:3202 TOWER OAKS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4219
Mailing Address - Country:US
Mailing Address - Phone:301-468-1101
Mailing Address - Fax:301-468-1101
Practice Address - Street 1:3202 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4219
Practice Address - Country:US
Practice Address - Phone:301-468-1001
Practice Address - Fax:301-468-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103TC0700X, 104100000X, 103T00000X
MDMD46680103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty