Healthcare Provider Details

I. General information

NPI: 1396465464
Provider Name (Legal Business Name): INSIGHTFUL SOURCE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 ARBOR OAKS DR
VACAVILLE CA
95687-5241
US

IV. Provider business mailing address

849 ARBOR OAKS DR
VACAVILLE CA
95687-5241
US

V. Phone/Fax

Practice location:
  • Phone: 707-342-6676
  • Fax:
Mailing address:
  • Phone:
  • 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
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIA PARELLA
Title or Position: LMFT
Credential:
Phone: 707-342-6676