Healthcare Provider Details

I. General information

NPI: 1013929074
Provider Name (Legal Business Name): INSIGHTFUL DYNAMICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5876 VASSAR
WEST BLOOMFIELD MI
48322-3544
US

IV. Provider business mailing address

5876 VASSAR
WEST BLOOMFIELD MI
48322-3544
US

V. Phone/Fax

Practice location:
  • Phone: 248-539-2116
  • Fax: 248-539-7203
Mailing address:
  • Phone: 248-539-2116
  • Fax: 248-539-7203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801060621
License Number StateMI

VIII. Authorized Official

Name: DEBORAH PERLMAN-AJLOUNY
Title or Position: PRESIDENT/PSYCHOTHERAPIST
Credential: MSW, LMSW, ACSW
Phone: 248-539-2116