Provider Demographics
NPI:1366628042
Name:INTEGRATIVE COUNSELING SERVICES
Entity Type:Organization
Organization Name:INTEGRATIVE COUNSELING SERVICES
Other - Org Name:ICS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCHANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PHD, LMFT
Authorized Official - Phone:520-403-4798
Mailing Address - Street 1:1624 E CALLE ALTIVO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5807
Mailing Address - Country:US
Mailing Address - Phone:520-403-4798
Mailing Address - Fax:520-325-7677
Practice Address - Street 1:4761 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1256
Practice Address - Country:US
Practice Address - Phone:520-403-4798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-12
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health