Provider Demographics
NPI:1700430493
Name:NEW INSIGHT COUNSELING PLLC
Entity Type:Organization
Organization Name:NEW INSIGHT COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LIMITED LIABILITY PSYCHOLOGIS
Authorized Official - Prefix:
Authorized Official - First Name:MICHELL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:616-366-6805
Mailing Address - Street 1:8020 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:COOPERSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49404-9794
Mailing Address - Country:US
Mailing Address - Phone:616-366-6805
Mailing Address - Fax:
Practice Address - Street 1:509 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1400
Practice Address - Country:US
Practice Address - Phone:616-366-6805
Practice Address - Fax:616-607-7322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty