Provider Demographics
NPI:1730714882
Name:INSIGHT COUNSELING PROFESSIONALS, PLLC
Entity type:Organization
Organization Name:INSIGHT COUNSELING PROFESSIONALS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LCASA BC-TMH
Authorized Official - Phone:336-943-5312
Mailing Address - Street 1:717 GREEN VALLEY RD STE 222
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2155
Mailing Address - Country:US
Mailing Address - Phone:336-690-9386
Mailing Address - Fax:336-907-4092
Practice Address - Street 1:717 GREEN VALLEY RD STE 222
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2155
Practice Address - Country:US
Practice Address - Phone:336-544-7679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty