Basic Information
| Provider Information | |||||||||
| NPI: | 1528451218 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INSIGHT PSYCHOLOGICAL SERVICES, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2124 JEFFERSON DAVIS HWY | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | STAFFORD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406580888 | ||||||||
| FaxNumber: | 5406580855 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 HOPE RD. | ||||||||
| Address2: | SUITE 213 | ||||||||
| City: | STAFFORD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406580888 | ||||||||
| FaxNumber: | 5406580855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2015 | ||||||||
| LastUpdateDate: | 03/05/2015 | ||||||||
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| AuthorizedOfficialLastName: | HEAD | ||||||||
| AuthorizedOfficialFirstName: | LYNNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | LICENSED PROFESSIONAL COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 2145029081 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LPC-S, RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 12707 | TX | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 224040 | TX | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 3536 | TX | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 0701005909 | VA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.