| Insightful Changes Counseling, Llc | |
|
94 Forest Meadow Trl Rochester NY 14624-1137 | |
| (716) 307-8403 | |
| Not Available |
| Full Name | Insightful Changes Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 94 Forest Meadow Trl, Rochester, New York |
| Authorized Official Name and Position | Kaitlee Derx (LCSW/OWNER) |
| Authorized Official Contact | 7163078403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insightful Changes Counseling, Llc 94 Forest Meadow Trl Rochester NY 14624-1137 Ph: (716) 307-8403 | Insightful Changes Counseling, Llc 94 Forest Meadow Trl Rochester NY 14624-1137 Ph: (716) 307-8403 |
| NPI Number | 1396597092 |
|---|---|
| Provider Enumeration Date | 04/04/2024 |
| Last Update Date | 06/23/2024 |
| Certification Date | 06/23/2024 |
| Medicare PECOS PAC ID | 4385188267 |
|---|---|
| Medicare Enrollment ID | O20240702003401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396597092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kaitlee Derx |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285097931 PECOS PAC ID: 3173067055 Enrollment ID: I20240702003656 |
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