| Integrative Health Services, Llc | |
|
500 Southland Drive Suite 109 Hoover AL 35226 | |
| (205) 427-6032 | |
| Not Available |
| Full Name | Integrative Health Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 500 Southland Drive, Hoover, Alabama |
| Authorized Official Name and Position | Marilyn Knight (OWNER/COUNSELOR) |
| Authorized Official Contact | 2054276032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Health Services, Llc 500 Southland Drive Suite 109 Hoover AL 35226 Ph: (205) 427-6032 | Integrative Health Services, Llc 500 Southland Drive Suite 109 Hoover AL 35226 Ph: (205) 427-6032 |
| NPI Number | 1417355504 |
|---|---|
| Provider Enumeration Date | 12/05/2014 |
| Last Update Date | 12/05/2014 |
| Medicare PECOS PAC ID | 0648503615 |
|---|---|
| Medicare Enrollment ID | O20190605003133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417355504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1140-3596C (Alabama) | Primary |
| Provider Name | Antonowsky D Coleman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063529485 PECOS PAC ID: 2860454626 Enrollment ID: I20041103000473 |
| Provider Name | Marilyn Knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740610302 PECOS PAC ID: 3274765169 Enrollment ID: I20140408000455 |
| Provider Name | John W Wise |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033641824 PECOS PAC ID: 6709256050 Enrollment ID: I20240105001132 |
| Provider Name | Jordan Vann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699300111 PECOS PAC ID: 4486007523 Enrollment ID: I20240125001184 |
| Provider Name | Lisa Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356816888 PECOS PAC ID: 6901249861 Enrollment ID: I20240207002232 |
| Provider Name | Luther Bufford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447859368 PECOS PAC ID: 2668815325 Enrollment ID: I20240209000582 |
| Provider Name | Mark M Banaszek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720621816 PECOS PAC ID: 3274976808 Enrollment ID: I20240209002938 |
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