| Insightful Life Therapeutic Services Llc | |
|
575 S Charles St Ste 140 Baltimore MD 21201-2477 | |
| (443) 873-7197 | |
| (443) 873-7198 |
| Full Name | Insightful Life Therapeutic Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 575 S Charles St Ste 140, Baltimore, Maryland |
| Authorized Official Name and Position | Stanley Nwogwugwu (CEO) |
| Authorized Official Contact | 4438737197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Insightful Life Therapeutic Services Llc 575 S Charles St Ste 140 Baltimore MD 21201-2477 Ph: (443) 873-7197 | Insightful Life Therapeutic Services Llc 575 S Charles St Ste 140 Baltimore MD 21201-2477 Ph: (443) 873-7197 |
| NPI Number | 1689033771 |
|---|---|
| Provider Enumeration Date | 02/17/2016 |
| Last Update Date | 01/25/2024 |
| Certification Date | 01/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689033771 | NPI | - | NPPES |
| 421854000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LCA1914 (Maryland) | Secondary |
| 101YP2500X | Counselor - Professional | LC2385 (Maryland) | Primary |
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