Provider Demographics
NPI:1457653610
Name:INSIGHTFUL LIVING INC
Entity type:Organization
Organization Name:INSIGHTFUL LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FULBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:972-905-9448
Mailing Address - Street 1:2770 MAIN ST STE 224
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4454
Mailing Address - Country:US
Mailing Address - Phone:972-905-9448
Mailing Address - Fax:972-688-6166
Practice Address - Street 1:2770 MAIN ST STE 224
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4454
Practice Address - Country:US
Practice Address - Phone:972-905-9448
Practice Address - Fax:972-905-9448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NV5767-C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty