Provider Demographics
NPI:1427439330
Name:INSIGHTFUL WAY MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:INSIGHTFUL WAY MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:DEL GUERCIO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:631-751-0413
Mailing Address - Street 1:PO BOX 1577
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0894
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:542 N COUNTRY RD
Practice Address - Street 2:2ND FL
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1439
Practice Address - Country:US
Practice Address - Phone:631-751-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006480261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)