MEDICARE: INSIGHT BEHAVIORAL HEALTH 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831683028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	2662 RAINBOW RIVER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-3639
Country	:	US
Telephone Number	:	702-670-1665
Fax Number	:

Provider Business Practice Location Address
First Line	:	2662 RAINBOW RIVER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-3639
Country	:	US
Telephone Number	:	702-670-1665
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MR. SHANDY CHANCE MELSON
Credential	:	MS, LCPC, LCADC-S
Telephone Number	:	702-670-1665

Provider Enumeration Date	:	06/20/2018
Last Update Date	:	06/20/2018

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