| Insightful Therapeutic Solutions Llc | |
|
4770 S Ridgewood Ave Port Orange FL 32127-4544 | |
| (386) 259-8071 | |
| (386) 204-8712 |
| Full Name | Insightful Therapeutic Solutions Llc |
|---|---|
| Speciality | Counselor |
| Location | 4770 S Ridgewood Ave, Port Orange, Florida |
| Authorized Official Name and Position | Liana Noelle Menendez (OWNER/OPERATOR) |
| Authorized Official Contact | 3862598071 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insightful Therapeutic Solutions Llc 4770 S Ridgewood Ave Port Orange FL 32127-4544 Ph: (386) 259-8071 | Insightful Therapeutic Solutions Llc 4770 S Ridgewood Ave Port Orange FL 32127-4544 Ph: (386) 259-8071 |
| NPI Number | 1558970491 |
|---|---|
| Provider Enumeration Date | 07/27/2020 |
| Last Update Date | 11/10/2022 |
| Certification Date | 11/10/2022 |
| Medicare PECOS PAC ID | 9830515014 |
|---|---|
| Medicare Enrollment ID | O20200818003799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558970491 | NPI | - | NPPES |
| 1093270290 | Other | FL | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Liana Noelle Menendez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093270290 PECOS PAC ID: 7517381262 Enrollment ID: I20200728001512 |
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