Provider Demographics
NPI:1801443775
Name:INSIGHTFUL CONNECTIONS COUNSELING, PLLC
Entity type:Organization
Organization Name:INSIGHTFUL CONNECTIONS COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PERCIVAL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:717-507-5555
Mailing Address - Street 1:199 SPOTNAP RD STE 6A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8827
Mailing Address - Country:US
Mailing Address - Phone:717-507-5555
Mailing Address - Fax:
Practice Address - Street 1:199 SPOTNAP RD STE 6A
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8827
Practice Address - Country:US
Practice Address - Phone:717-507-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-24
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty