Provider Demographics
NPI:1033580089
Name:INTEGRATED COMMUNITY THERAPISTS, LLC
Entity Type:Organization
Organization Name:INTEGRATED COMMUNITY THERAPISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVELLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CADC
Authorized Official - Phone:319-337-3357
Mailing Address - Street 1:123 N LINN ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2143
Mailing Address - Country:US
Mailing Address - Phone:319-337-3357
Mailing Address - Fax:319-337-2758
Practice Address - Street 1:123 N LINN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2143
Practice Address - Country:US
Practice Address - Phone:319-337-3357
Practice Address - Fax:319-337-2758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty