Provider Demographics
NPI:1902076516
Name:INSIGHT PSYCHOLOGICAL CONSULTANTS, PSC
Entity Type:Organization
Organization Name:INSIGHT PSYCHOLOGICAL CONSULTANTS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:EBBEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:502-848-0201
Mailing Address - Street 1:106 PROGRESS DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-8695
Mailing Address - Country:US
Mailing Address - Phone:502-848-0201
Mailing Address - Fax:502-848-0203
Practice Address - Street 1:106 PROGRESS DR
Practice Address - Street 2:SUITE B
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-8695
Practice Address - Country:US
Practice Address - Phone:502-848-0201
Practice Address - Fax:502-848-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYINSIGHT010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY89009757Medicaid
KY89009757Medicaid