Provider Demographics
NPI:1700321833
Name:INSIGHT PSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:INSIGHT PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-443-3112
Mailing Address - Street 1:4611 PLETTNER LN
Mailing Address - Street 2:STE. 100
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4611 PLETTNER LN
Practice Address - Street 2:STE. 100
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7396
Practice Address - Country:US
Practice Address - Phone:720-443-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004027251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health