MEDICARE: INSIGHTFUL GROWTH COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1780386573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHTFUL GROWTH COUNSELING LLC

Provider Business Mailing Address
First Line	:	6059 ALLENTOWN BLVD # 266
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-2672
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 WINDING CREEK BLVD
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17050-1883
Country	:	US
Telephone Number	:	717-208-2215
Fax Number	:

Authorized Official
Title or Position	:	CCO
Name	:	DEBRA WOLFORD
Credential	:
Telephone Number	:	717-208-2215

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	03/17/2023

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