=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881897593
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INSIGHT THERAPIES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23 BAYBERRY RD
-----------------------------------------------------
City | WESTFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01886-2407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-692-2100
-----------------------------------------------------
Fax | 978-692-2189
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23 BAYBERRY RD
-----------------------------------------------------
City | WESTFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01886-2407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-692-2100
-----------------------------------------------------
Fax | 978-692-2189
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JANE MARTINEZ
-----------------------------------------------------
Credential | LICSW
-----------------------------------------------------
Telephone | 978-692-2100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 1032177
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------