Provider Demographics
NPI:1295813244
Name:INSIGHT PSYCHOLOGICAL & COUNSELING INC.
Entity type:Organization
Organization Name:INSIGHT PSYCHOLOGICAL & COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:304-757-8650
Mailing Address - Street 1:1401 HOSPITAL DR
Mailing Address - Street 2:STE # 106
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9237
Mailing Address - Country:US
Mailing Address - Phone:304-757-8650
Mailing Address - Fax:304-757-0633
Practice Address - Street 1:1401 HOSPITAL DR
Practice Address - Street 2:STE # 106
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9237
Practice Address - Country:US
Practice Address - Phone:304-757-8650
Practice Address - Fax:304-757-0633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0202137000Medicaid
WV001710635OtherBLUE CROSS BLUE SHIELD
WV=========OtherTAX ID #