Provider Demographics
NPI:1437453149
Name:INTEGRATIVE HEALTH PSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTH PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MPH
Authorized Official - Phone:212-481-1100
Mailing Address - Street 1:51 E 25TH ST
Mailing Address - Street 2:SUITE 7-I
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2945
Mailing Address - Country:US
Mailing Address - Phone:212-481-1100
Mailing Address - Fax:
Practice Address - Street 1:51 E 25TH ST
Practice Address - Street 2:SUITE 7-I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2945
Practice Address - Country:US
Practice Address - Phone:212-481-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018874261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health