MEDICARE: INSIGHT MENTAL HEALTH

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1366034613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT MENTAL HEALTH

Provider Business Mailing Address
First Line	:	3206 LONGMIRE DR STE A72
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-5858
Country	:	US
Telephone Number	:	979-217-1116
Fax Number	:

Provider Business Practice Location Address
First Line	:	3206 LONGMIRE DR STE A72
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-5858
Country	:	US
Telephone Number	:	979-217-1116
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	JAMIE MARIE MANNING
Credential	:	LPC
Telephone Number	:	979-217-1116

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	02/08/2021

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Directions to “INSIGHT MENTAL HEALTH ” Practice Location

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