Healthcare Provider Details

I. General information

NPI: 1578081014
Provider Name (Legal Business Name): INSIGHT OUT THERAPEUTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W JONATHON DR
WASHINGTON UT
84780-3126
US

IV. Provider business mailing address

921 W JONATHON DR
WASHINGTON UT
84780-3126
US

V. Phone/Fax

Practice location:
  • Phone: 435-229-5031
  • Fax: 435-236-6066
Mailing address:
  • Phone: 435-229-5031
  • Fax: 435-236-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLPC009358
License Number StateGA

VIII. Authorized Official

Name: MR. CHARLES ARTHUR LENAHAN
Title or Position: CEO
Credential: LPC
Phone: 678-472-7347