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General NPI Number Information
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NPI Number | 1467716886
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Entity Type | Organization
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Legal Business Name | INSIGHTFUL COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 1103 SW 2ND AVE. CEDAR HEALTHCARE
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City | GAINESVILLE
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State | FL
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Zip | 32601
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Country | US
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Telephone | 352-378-9116
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 SW 2ND AVE CEDAR HEALTHCARE
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City | GAINESVILLE
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State | FL
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Zip | 32601
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Country | US
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Telephone | 352-378-9116
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Fax | 352-378-9779
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TALANA SIEVERT KERSEY M.S. LMHC
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Credential | M.S. LMHC
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Telephone | 352-591-4348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH5742
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License Number State | FL
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