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General NPI Number Information
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NPI Number | 1194854802
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Entity Type | Organization
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Legal Business Name | INSIGHT COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1777 REISTERSTOWN RD STE 395
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City | BALTIMORE
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State | MD
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Zip | 21208-6318
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Country | US
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Telephone | 410-580-2045
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Fax | 410-356-9112
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Provider Business Mailing Address
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Address Line | 1777 REISTERSTOWN RD STE 395
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City | BALTIMORE
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State | MD
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Zip | 21208-6318
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Country | US
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Telephone | 410-580-2045
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Fax | 410-356-9112
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRUCE E. BERTELL
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Credential | MSW
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Telephone | 410-580-2045
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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 | 03644
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License Number State | MD
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