NPIMap

Organization Active NPI

Insightful Life Therapeutic Services LLC

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1689033771
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC2385 Issued in MD
Legal business name
INSIGHTFUL LIFE THERAPEUTIC SERVICES LLC
Practice address
575 S Charles St Ste 140
Baltimore, MD 21201-2477
Phone
(443) 873-7197
Fax
(443) 873-7198
NPI assigned
Feb 17, 2016
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Stanley Nwogwugwu, LCPC, LCADC, NCCNPI 1033393202
Title
Ceo
Phone
(443) 873-7197

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCA1914 MD
Professional Counselor 101YP2500X LC2385 MD Primary

Addresses

Primary practice location

575 S Charles St Ste 140
Baltimore, MD 21201-2477

Mailing address

575 S Charles St Ste 140
Baltimore, MD 21201-2477
Phone (443) 873-7197

Other identifiers 1

IdentifierTypeStateIssuer
421854000MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Insightful Life Thera Srvcs4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1689033771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 S CHARLES ST STE 140",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012477",
            "telephone_number": "443-873-7197",
            "fax_number": "443-873-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 S CHARLES ST STE 140",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012477",
            "telephone_number": "443-873-7197",
            "fax_number": "443-873-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSIGHTFUL LIFE THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "NWOGWUGWU",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-873-7197",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC, LCADC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA1914",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC2385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421854000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.