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General NPI Number Information
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NPI Number | 1366552333
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Entity Type | Organization
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Legal Business Name | INSIGHT BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1831B FOREST DR STE B
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City | ANNAPOLIS
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State | MD
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Zip | 21401-4429
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Country | US
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Telephone | 410-280-0990
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Fax | 410-280-0990
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Provider Business Mailing Address
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Address Line | 390 MAPLE TRL
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City | CROWNSVILLE
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State | MD
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Zip | 21032-1729
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Country | US
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Telephone | 410-905-2808
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Fax |
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Authorized Official
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Title or Position | THERAPIST/SOLE PROPRIETOR
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Name | MR. THOMAS BANKS WETMORE
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Credential | LCSW-C
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Telephone | 410-280-0990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 12570
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License Number State | MD
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