Healthcare Provider Details

I. General information

NPI: 1164241295
Provider Name (Legal Business Name): INSIGHTFUL CONNECTIONS COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 W 2ND STREET
CONSTANTINE MI
49042
US

IV. Provider business mailing address

PO BOX 5
CONSTANTINE MI
49042-0005
US

V. Phone/Fax

Practice location:
  • Phone: 269-816-3334
  • Fax:
Mailing address:
  • Phone: 269-816-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HAGERTY
Title or Position: OWNER/PRESIDENT
Credential: LMSW
Phone: 269-816-3334