Healthcare Provider Details

I. General information

NPI: 1548733967
Provider Name (Legal Business Name): NEW INSIGHT INTEGRATED HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 1ST AVE N STE A
BIRMINGHAM AL
35206-4213
US

IV. Provider business mailing address

813 PARK AVE
FAIRFIELD AL
35064-1545
US

V. Phone/Fax

Practice location:
  • Phone: 205-215-3980
  • Fax:
Mailing address:
  • Phone: 205-215-3980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DEIRDRE CROCHEN ROSE
Title or Position: CEO
Credential: LPC
Phone: 205-381-4445