Provider Demographics
NPI:1174121297
Name:INSIGHT BEHAVIOR PARTNERSHIP, LLC
Entity type:Organization
Organization Name:INSIGHT BEHAVIOR PARTNERSHIP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:ADDLESON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:720-507-5226
Mailing Address - Street 1:325 INVERNESS DR S
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6012
Mailing Address - Country:US
Mailing Address - Phone:720-507-5226
Mailing Address - Fax:
Practice Address - Street 1:325 INVERNESS DR S
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-6012
Practice Address - Country:US
Practice Address - Phone:720-507-5226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSIGHT BEHAVIOR PARTNERSHIP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000162551Medicaid
CO9000164692Medicaid