| Insight Psychotherapy Llc | |
|
7766 Buckboard Dr Park City UT 84098-5315 | |
| (801) 879-1444 | |
| Not Available |
| Full Name | Insight Psychotherapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7766 Buckboard Dr, Park City, Utah |
| Authorized Official Name and Position | Samuel Grey Walter (OWNER) |
| Authorized Official Contact | 8018791444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insight Psychotherapy Llc 7766 Buckboard Dr Park City UT 84098-5315 Ph: (801) 879-1444 | Insight Psychotherapy Llc 7766 Buckboard Dr Park City UT 84098-5315 Ph: (801) 879-1444 |
| NPI Number | 1932813292 |
|---|---|
| Provider Enumeration Date | 01/11/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Medicare PECOS PAC ID | 7416302161 |
|---|---|
| Medicare Enrollment ID | O20231016002187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932813292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Samuel Grey Walter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730468455 PECOS PAC ID: 8022338813 Enrollment ID: I20150519000921 |
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