| Integrative Psychotherapy Inc. | |
|
63 El Pavo Real Cir San Rafael CA 94903-3520 | |
| (415) 250-2316 | |
| Not Available |
| Full Name | Integrative Psychotherapy Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 63 El Pavo Real Cir, San Rafael, California |
| Authorized Official Name and Position | Michelle Rowley (PRESIDENT) |
| Authorized Official Contact | 4152502316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Psychotherapy Inc. 38 Miller Ave # 221 Mill Valley CA 94941-1927 Ph: (415) 250-2316 | Integrative Psychotherapy Inc. 63 El Pavo Real Cir San Rafael CA 94903-3520 Ph: (415) 250-2316 |
| NPI Number | 1497413694 |
|---|---|
| Provider Enumeration Date | 12/04/2021 |
| Last Update Date | 12/04/2021 |
| Certification Date | 12/04/2021 |
| Medicare PECOS PAC ID | 6406249192 |
|---|---|
| Medicare Enrollment ID | O20220201001477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497413694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michelle Alexandra Rowley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831853746 PECOS PAC ID: 7214320902 Enrollment ID: I20220201001566 |
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