Provider Demographics
NPI:1831405943
Name:INSIGHT EDUCATIONAL AND PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:INSIGHT EDUCATIONAL AND PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-330-9833
Mailing Address - Street 1:PO BOX 40073
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-0073
Mailing Address - Country:US
Mailing Address - Phone:817-330-9833
Mailing Address - Fax:
Practice Address - Street 1:5620 SW GREEN OAKS BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1160
Practice Address - Country:US
Practice Address - Phone:817-330-9833
Practice Address - Fax:817-478-6525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33726103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty