Provider Demographics
NPI:1295265783
Name:INSIGHT COUNSELING DULUTH, LLC
Entity type:Organization
Organization Name:INSIGHT COUNSELING DULUTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLABAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LGSW
Authorized Official - Phone:218-481-7660
Mailing Address - Street 1:5223 PINE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803
Mailing Address - Country:US
Mailing Address - Phone:218-481-7660
Mailing Address - Fax:218-216-1452
Practice Address - Street 1:306 W SUPERIOR ST STE 1000
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1818
Practice Address - Country:US
Practice Address - Phone:218-428-0048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111951041C0700X
MN106H00000X
364SP0808X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty