1417322371 NPI number — INSIGHT BEHAVIORAL HEALTH & ADDICTION SOLUTIONS, INC.

Table of content: MS. PAMELA KAY WILLIAMSON MSW ACSW LICSW (NPI 1528112059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417322371 NPI number — INSIGHT BEHAVIORAL HEALTH & ADDICTION SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSIGHT BEHAVIORAL HEALTH & ADDICTION SOLUTIONS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417322371
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
508 W FLETCHER AVE
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33612-3413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-271-7332
Provider Business Mailing Address Fax Number:
954-369-5038

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
508 W FLETCHER AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33612-3413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-271-7332
Provider Business Practice Location Address Fax Number:
954-369-5038
Provider Enumeration Date:
12/03/2015

Additional Information

Authorized Official

Authorized Official Last Name:
TZATZIMAKIS
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
888-330-2532

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X , with the licence number: 2901 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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