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General NPI Number Information
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NPI Number | 1710695804
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Entity Type | Organization
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Legal Business Name | INSIGHTFUL MINDS THERAPY
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 26105 ORCHARD LAKE RD STE 203
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-4578
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Country | US
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Telephone | 248-459-6538
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Fax |
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Provider Business Mailing Address
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Address Line | 26105 ORCHARD LAKE RD STE 203
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-4578
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HOLLY DOERR
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Credential |
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Telephone | 248-459-6538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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