Provider Demographics
NPI:1477946507
Name:INTEGRATED PSYCHOLOGICAL HEALTH & WELLNESS PLLC
Entity Type:Organization
Organization Name:INTEGRATED PSYCHOLOGICAL HEALTH & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:607-481-1194
Mailing Address - Street 1:351 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2723
Mailing Address - Country:US
Mailing Address - Phone:067-481-1194
Mailing Address - Fax:607-398-7976
Practice Address - Street 1:351 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2723
Practice Address - Country:US
Practice Address - Phone:067-481-1194
Practice Address - Fax:607-398-7976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018932103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty