Provider Demographics
NPI:1245101047
Name:AUTHENTIC INSIGHT PSYCHOLOGY PLLC
Entity type:Organization
Organization Name:AUTHENTIC INSIGHT PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:GULYAYEVA
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-201-0492
Mailing Address - Street 1:31 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3009
Mailing Address - Country:US
Mailing Address - Phone:347-201-0492
Mailing Address - Fax:
Practice Address - Street 1:31 W 34TH ST
Practice Address - Street 2:8TH FL PMB 8093
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3009
Practice Address - Country:US
Practice Address - Phone:347-201-0492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty