Healthcare Provider Details

I. General information

NPI: 1306268396
Provider Name (Legal Business Name): INSIGHT COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 UNIVERSITY DR STE 140
AUBURN HILLS MI
48326-4606
US

IV. Provider business mailing address

3121 UNIVERSITY DR STE 140
AUBURN HILLS MI
48326-4606
US

V. Phone/Fax

Practice location:
  • Phone: 248-923-2099
  • Fax: 248-923-2096
Mailing address:
  • Phone: 248-670-2860
  • Fax: 248-923-2096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801084631
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301013009
License Number StateMI

VIII. Authorized Official

Name: DR. DOUGLAS W CARPENTER
Title or Position: FOUNDING MEMBER
Credential: PSY.D.
Phone: 248-670-2861