Provider Demographics
NPI:1366199077
Name:INSIGHT COUNSELING GORGE, PLCC
Entity type:Organization
Organization Name:INSIGHT COUNSELING GORGE, PLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ARAGON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LCSW
Authorized Official - Phone:503-577-9635
Mailing Address - Street 1:176 E JEWETT BLVD # 2290
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-8976
Mailing Address - Country:US
Mailing Address - Phone:503-577-9635
Mailing Address - Fax:
Practice Address - Street 1:176 E JEWETT BLVD # 2290
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-8976
Practice Address - Country:US
Practice Address - Phone:503-577-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)