Healthcare Provider Details

I. General information

NPI: 1710695804
Provider Name (Legal Business Name): INSIGHTFUL MINDS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26105 ORCHARD LAKE RD STE 203
FARMINGTON HILLS MI
48334-4578
US

IV. Provider business mailing address

26105 ORCHARD LAKE RD STE 203
FARMINGTON HILLS MI
48334-4578
US

V. Phone/Fax

Practice location:
  • Phone: 248-459-6538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: HOLLY DOERR
Title or Position: OWNER
Credential:
Phone: 248-459-6538