Provider Demographics
NPI:1164001152
Name:INTEGRATIVE THERAPY SYSTEMS
Entity Type:Organization
Organization Name:INTEGRATIVE THERAPY SYSTEMS
Other - Org Name:RODERIC BURKS, MA, MS HSC, MS, LPC
Other - Org Type:Other Name
Authorized Official - Title/Position:ONWER - CINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MS HSC, MS, LPC
Authorized Official - Phone:720-334-1864
Mailing Address - Street 1:9609 S UNIVERSITY BLVD UNIT 630015
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80163-3000
Mailing Address - Country:US
Mailing Address - Phone:720-334-1864
Mailing Address - Fax:720-230-5072
Practice Address - Street 1:1776 SOUTH JACKSON STREET
Practice Address - Street 2:#211
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210
Practice Address - Country:US
Practice Address - Phone:720-334-1864
Practice Address - Fax:720-230-5072
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RODERIC BURKS MA, MS HSC, MS, LPC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-06
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty