Healthcare Provider Details

I. General information

NPI: 1902076516
Provider Name (Legal Business Name): INSIGHT PSYCHOLOGICAL CONSULTANTS, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 PROGRESS DR SUITE B
FRANKFORT KY
40601-8695
US

IV. Provider business mailing address

106 PROGRESS DR SUITE B
FRANKFORT KY
40601-8695
US

V. Phone/Fax

Practice location:
  • Phone: 502-848-0201
  • Fax: 502-848-0203
Mailing address:
  • Phone: 502-848-0201
  • Fax: 502-848-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberINSIGHT010
License Number StateKY

VIII. Authorized Official

Name: DR. PAUL ANTHONY EBBEN
Title or Position: PRESIDENT/PSYCHOLOGIST
Credential: PSY.D.
Phone: 502-848-0201