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General NPI Number Information
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NPI Number | 1164241295
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Entity Type | Organization
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Legal Business Name | INSIGHTFUL CONNECTIONS COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 128 W 2ND STREET
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City | CONSTANTINE
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State | MI
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Zip | 49042
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Country | US
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Telephone | 269-816-3334
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5
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City | CONSTANTINE
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State | MI
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Zip | 49042-0005
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Country | US
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Telephone | 269-816-3334
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JENNIFER HAGERTY
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Credential | LMSW
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Telephone | 269-816-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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