Provider Demographics
NPI:1073669875
Name:INTEGRATED THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:INTEGRATED THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHRFELD
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:631-433-0033
Mailing Address - Street 1:2938 BAYSWATER AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1730
Mailing Address - Country:US
Mailing Address - Phone:631-433-0033
Mailing Address - Fax:
Practice Address - Street 1:2938 BAYSWATER AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1730
Practice Address - Country:US
Practice Address - Phone:631-433-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVWW411Medicare ID - Type UnspecifiedEMPIRE MEDICARE