| Insightful Pediatric And Family Therapy, Llc | |
|
164 Churchill Dr Sparta TN 38583-1525 | |
| (931) 246-9449 | |
| Not Available |
| Full Name | Insightful Pediatric And Family Therapy, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 164 Churchill Dr, Sparta, Tennessee |
| Authorized Official Name and Position | Isha Chaney (LPC-MHSP) |
| Authorized Official Contact | 9312469449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insightful Pediatric And Family Therapy, Llc 2158 Wynd Walker Dr Cookeville TN 38506-5698 Ph: () - | Insightful Pediatric And Family Therapy, Llc 164 Churchill Dr Sparta TN 38583-1525 Ph: (931) 246-9449 |
| NPI Number | 1174098321 |
|---|---|
| Provider Enumeration Date | 10/03/2018 |
| Last Update Date | 09/18/2023 |
| Certification Date | 09/18/2023 |
| Medicare PECOS PAC ID | 4981073475 |
|---|---|
| Medicare Enrollment ID | O20221205002108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174098321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Teresa Benson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568113637 PECOS PAC ID: 5193194694 Enrollment ID: I20221205002406 |
| Provider Name | Lori Chaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619671070 PECOS PAC ID: 8022487511 Enrollment ID: I20230706000642 |
| Provider Name | Tara Cook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619586138 PECOS PAC ID: 9537510102 Enrollment ID: I20240108004681 |
| Provider Name | Isha S Chaney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225548340 PECOS PAC ID: 5496124984 Enrollment ID: I20240206003679 |
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