Healthcare Provider Details

I. General information

NPI: 1295813244
Provider Name (Legal Business Name): INSIGHT PSYCHOLOGICAL & COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HOSPITAL DR STE # 106
HURRICANE WV
25526-9237
US

IV. Provider business mailing address

1401 HOSPITAL DR STE # 106
HURRICANE WV
25526-9237
US

V. Phone/Fax

Practice location:
  • Phone: 304-757-8650
  • Fax: 304-757-0633
Mailing address:
  • Phone: 304-757-8650
  • Fax: 304-757-0633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number StateWV

VIII. Authorized Official

Name: MR. BRUCE E CLAY
Title or Position: PSYCHOLOGIST
Credential: MA
Phone: 304-757-8650