Healthcare Provider Details

I. General information

NPI: 1225955511
Provider Name (Legal Business Name): INSIGHTFUL EDGE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1877 S FEDERAL HWY STE 310
BOCA RATON FL
33432-7411
US

IV. Provider business mailing address

1877 S FEDERAL HWY STE 310
BOCA RATON FL
33432-7411
US

V. Phone/Fax

Practice location:
  • Phone: 954-614-9622
  • Fax:
Mailing address:
  • Phone: 954-614-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHASE MARTIN SCOTT
Title or Position: SOLE MBR
Credential: LMHC
Phone: 954-614-9622