Organization
INSIGHT RENEWAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MCCARTHER (COO/CFO)
(504) 414-0111
Entity
Organization
Contact information
Practice address
12410 CANTRELL RD STE 202, LITTLE ROCK, AR 72223-0038
(015) 414-0111
(501) 222-1309
Mailing address
12410 CANTRELL RD STE 202, LITTLE ROCK, AR 72223-0038
(501) 414-0111
(501) 222-1309
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1307-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225580913
GROUP NPI NUMBER
AR
01
—
1356431928
INDIVIDUAL NPI NUMBER
AR
01
—
40904
MHN
AR
01
—
508460000-00
QUALCHOICE/QCA
AR
01
—
5W213
ARKANSAS BCBS PPP
AR
01
—
BW213
TRUE BLUE PPO
AR
Enumeration date
10/27/2016
Last updated
07/25/2023
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