Healthcare Provider Details

I. General information

NPI: 1578721189
Provider Name (Legal Business Name): INSIGHT PSYCHOTHERAPY & ASSESSMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 DAWSON RD
ALBANY GA
31707-3306
US

IV. Provider business mailing address

1908 DAWSON RD
ALBANY GA
31707-3306
US

V. Phone/Fax

Practice location:
  • Phone: 229-431-1107
  • Fax: 229-436-5042
Mailing address:
  • Phone: 229-431-1107
  • Fax: 229-436-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number2850
License Number StateGA

VIII. Authorized Official

Name: DR. CHERYL L KAISER-ULREY
Title or Position: PSYCHOLOGIST/OWNER
Credential: PH.D.
Phone: 229-431-1107