Provider Demographics
NPI:1114359882
Name:INTEGRATIVE EMPOWERMENT GROUP, PLLC
Entity Type:Organization
Organization Name:INTEGRATIVE EMPOWERMENT GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:ALEASE
Authorized Official - Last Name:NABORS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-635-8830
Mailing Address - Street 1:124 PEARL ST STE 207
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-5375
Mailing Address - Country:US
Mailing Address - Phone:734-717-2136
Mailing Address - Fax:
Practice Address - Street 1:124 PEARL ST STE 207
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-5375
Practice Address - Country:US
Practice Address - Phone:734-717-2136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty