Healthcare Provider Details

I. General information

NPI: 1861132771
Provider Name (Legal Business Name): INSIGHT COUNSELING GORGE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 E JEWETT BLVD # 2290-107
WHITE SALMON WA
98672-8976
US

IV. Provider business mailing address

176 E JEWETT BLVD # 2290
WHITE SALMON WA
98672-8976
US

V. Phone/Fax

Practice location:
  • Phone: 509-262-5753
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LESLIE NICOLE ARAGON
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 509-262-5753