Provider Demographics
NPI:1275356909
Name:INSIGHT LICENSED PROFESSIONAL CLINICAL COUNSELOR AND FAMILY THERAPY
Entity type:Organization
Organization Name:INSIGHT LICENSED PROFESSIONAL CLINICAL COUNSELOR AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MACY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPCC
Authorized Official - Phone:831-222-0455
Mailing Address - Street 1:1146 SOQUEL AVE UNIT 4071
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-1085
Mailing Address - Country:US
Mailing Address - Phone:831-222-0455
Mailing Address - Fax:
Practice Address - Street 1:1835 PORTOLA DR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4918
Practice Address - Country:US
Practice Address - Phone:831-222-0455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty