Integrative Psychological Center Llc
LBN: Integrative Psychological Center Llc
Integrative Psychological Center Llc is an health care organization with primary practice located at 44 Capitol Ave Ste 402 , Hartford CT 06106-1764. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Psychologist is the primary health care specialty.
Integrative Psychological Center Llc can be contacted via phone (860) 466-9411, or through Wallace, Randall via phone (860) 466-9411.
Contact Information
Primary practice address
44 Capitol Ave Ste 402
Hartford CT 06106-1764
Phone: (860) 466-9411
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | ||
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X |
Profile Details
| NPI number | 1306318670 |
|---|---|
| LBN Legal business name | Integrative Psychological Center Llc |
| DBA Doing business as | |
| Authorized official | Wallace, Randall PSYD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 26th, 2018 |
| Last updated | Dec 26th, 2018 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306318670 | NPPES |
| Connecticut | MEDICAID | 008042490 |
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