Healthcare Provider Details

I. General information

NPI: 1619727690
Provider Name (Legal Business Name): KBS INSIGHTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3298 SUMMIT BLVD BLDG 22, SUITE D1
PENSACOLA FL
32503-8313
US

IV. Provider business mailing address

3298 SUMMIT BLVD BLDG 22, SUITE D1
PENSACOLA FL
32503-8313
US

V. Phone/Fax

Practice location:
  • Phone: 850-977-9215
  • Fax:
Mailing address:
  • Phone: 850-977-9215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN SHACKET
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 850-977-9215