Provider Demographics
NPI:1578081014
Name:INSIGHT OUT THERAPEUTICS, LLC
Entity type:Organization
Organization Name:INSIGHT OUT THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:LENAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-472-7347
Mailing Address - Street 1:921 W JONATHON DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-3126
Mailing Address - Country:US
Mailing Address - Phone:435-229-5031
Mailing Address - Fax:435-236-6066
Practice Address - Street 1:921 W JONATHON DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-3126
Practice Address - Country:US
Practice Address - Phone:435-229-5031
Practice Address - Fax:435-236-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009358251S00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health