Organization
INSIGHTFUL LIFE THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANLEY NWOGWUGWU LCPC, LCADC, NCC (CEO)
(443) 873-7197
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
(443) 873-7198
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA1914
MD
101YP2500X
Professional Counselor
Primary
LC2385
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421854000
—
MD
Enumeration date
02/17/2016
Last updated
01/25/2024
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