Provider Demographics
NPI:1174058598
Name:INSIGHTFULWAYS CORP
Entity type:Organization
Organization Name:INSIGHTFULWAYS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:BROUGHTON
Authorized Official - Last Name:EGGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:209-342-7309
Mailing Address - Street 1:P.O. BOX 2333
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95381
Mailing Address - Country:US
Mailing Address - Phone:209-620-8464
Mailing Address - Fax:209-850-9411
Practice Address - Street 1:384 E OLIVE AVE STE 2
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380
Practice Address - Country:US
Practice Address - Phone:209-620-8464
Practice Address - Fax:209-850-9411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-23
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW71348251S00000X, 251S00000X
CA71348251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health