MEDICARE: INSIGHT THERAPEUTIC SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	3720C	AL

General Provider Information

NPI Number	:	1134669922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT THERAPEUTIC SERVICES, LLC

Provider Business Mailing Address
First Line	:	1 PERIMETER PARK S STE 100N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-3248
Country	:	US
Telephone Number	:	205-936-2356
Fax Number	:	205-273-5033

Provider Business Practice Location Address
First Line	:	1 PERIMETER PARK S STE 100N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-3248
Country	:	US
Telephone Number	:	205-936-2356
Fax Number	:	205-273-5033

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MS. VICTORIA LYNN FRAZIER
Credential	:	LICSW PIP
Telephone Number	:	205-936-2356

Provider Enumeration Date	:	02/28/2017
Last Update Date	:	10/15/2024

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