Basic Information
| Provider Information | |||||||||
| NPI: | 1538820600 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INSIGHT INVERSE COUNSELING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 337 ELM ST | ||||||||
| Address2: | |||||||||
| City: | STONINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063782928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606500053 | ||||||||
| FaxNumber: | 5084331871 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 BOSTON POST RD FL 1 | ||||||||
| Address2: | |||||||||
| City: | WATERFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063852401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606500053 | ||||||||
| FaxNumber: | 5084331871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2021 | ||||||||
| LastUpdateDate: | 12/31/2021 | ||||||||
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| AuthorizedOfficialLastName: | ALEXANDER-SSEBAGALA | ||||||||
| AuthorizedOfficialFirstName: | THERESE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8606500053 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LICSW | ||||||||
| NPICertificationDate: | 12/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.