Provider Demographics
NPI:1699118802
Name:INSIGHT BROOKLINE PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:INSIGHT BROOKLINE PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-834-4235
Mailing Address - Street 1:114 THURSTON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON UPPER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1200
Mailing Address - Country:US
Mailing Address - Phone:617-834-4235
Mailing Address - Fax:
Practice Address - Street 1:114 THURSTON RD
Practice Address - Street 2:
Practice Address - City:NEWTON UPPER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02464-1200
Practice Address - Country:US
Practice Address - Phone:617-834-4235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty