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General NPI Number Information
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NPI Number | 1174058598
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Entity Type | Organization
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Legal Business Name | INSIGHTFULWAYS CORP
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Dates
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Enumeration Date | 04/23/2017
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 384 E OLIVE AVE STE 2
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City | TURLOCK
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State | CA
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Zip | 95380
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Country | US
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Telephone | 209-620-8464
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Fax | 209-850-9411
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Provider Business Mailing Address
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Address Line | P.O. BOX 2333
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City | TURLOCK
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State | CA
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Zip | 95381
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Country | US
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Telephone | 209-620-8464
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Fax | 209-850-9411
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Authorized Official
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Title or Position | CLINICIAN/CO-OWNER
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Name | NICHOLAS BROUGHTON EGGER
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Credential | LCSW
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Telephone | 209-342-7309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCSW71348
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License Number State | CA
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