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NPI Code Detail

MEDICARE: INSIGHT DYNAMICS LLC

MEDICARE: INSIGHT DYNAMICS 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
1104100000XSocial Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710698402
Entity Type Code : Organization
Provider Name (Legal Business Name) : INSIGHT DYNAMICS LLC
Provider Business Mailing Address
First Line : 413 E SPRING ST
Second Line :
City : BOONVILLE
State : MO
Zip : 65233-1573
Country : US
Telephone Number : 166-088-2640
Fax Number :
Provider Business Practice Location Address
First Line : 413 E SPRING ST
Second Line :
City : BOONVILLE
State : MO
Zip : 65233-1573
Country : US
Telephone Number : 166-088-2640
Fax Number :
Authorized Official
Title or Position : LICENSED CLINICAL SOCIAL WORKER
Name : ANEISA LYNN SHERRILL-MATTOX
Credential : LCSW
Telephone Number : 660-882-6400
Provider Enumeration Date : 12/13/2022
Last Update Date : 12/13/2022

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Directions to “INSIGHT DYNAMICS LLC ” Practice Location

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