Healthcare Provider Details

I. General information

NPI: 1407774755
Provider Name (Legal Business Name): ENSIGHTFUL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LELAND WAY
BURBANK CA
91504-4113
US

IV. Provider business mailing address

8549 WILSHIRE BLVD # 2489
BEVERLY HILLS CA
90211-3104
US

V. Phone/Fax

Practice location:
  • Phone: 424-279-4288
  • Fax:
Mailing address:
  • Phone: 424-279-4288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARKUS ISSAC HICKS
Title or Position: OWNER
Credential:
Phone: 424-279-4288