Provider Demographics
NPI:1255119830
Name:INSIGHT TO CLINICAL THERAPY LCSW PLLC
Entity type:Organization
Organization Name:INSIGHT TO CLINICAL THERAPY LCSW PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:315-658-6496
Mailing Address - Street 1:600 OSWEGO ST
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5178
Mailing Address - Country:US
Mailing Address - Phone:315-760-4589
Mailing Address - Fax:315-457-6000
Practice Address - Street 1:600 OSWEGO ST
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-5178
Practice Address - Country:US
Practice Address - Phone:315-658-6496
Practice Address - Fax:315-457-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty