Provider Demographics
NPI:1326793605
Name:IRIDESCENT INTEGRATED HEALTH
Entity Type:Organization
Organization Name:IRIDESCENT INTEGRATED HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ZIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, BHP
Authorized Official - Phone:512-910-4547
Mailing Address - Street 1:2520 LONGVIEW ST STE 315
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-4237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2520 LONGVIEW ST STE 315
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4237
Practice Address - Country:US
Practice Address - Phone:512-910-4547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty