Organization
INSIGHTFUL LIFE THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY NWOGWUGWU LCPC, LCADC (DIRECTOR)
(443) 722-1649
Entity
Organization
Contact information
Practice address
575 S CHARLES ST STE 140, BALTIMORE, MD 21201-2477
(443) 873-7197
(443) 873-7198
Mailing address
575 S CHARLES ST STE 140, BALTIMORE, MD 21201-2477
(443) 873-7197
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4438
MD
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH-60
—
MD
Enumeration date
08/06/2013
Last updated
01/25/2024
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