Provider Demographics
NPI:1235930132
Name:DIVERGENT INSIGHTS THERAPY LLC
Entity type:Organization
Organization Name:DIVERGENT INSIGHTS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATEEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-534-9673
Mailing Address - Street 1:9190 VALLEY SPRING CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7815
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9190 VALLEY SPRING CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7815
Practice Address - Country:US
Practice Address - Phone:702-793-4493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty