Provider Demographics
NPI:1497216451
Name:INTEGRATIVE MENTAL HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:INTEGRATIVE MENTAL HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PC
Authorized Official - Phone:706-755-5324
Mailing Address - Street 1:540 SAINT ANDREWS RD STE 215
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-4581
Mailing Address - Country:US
Mailing Address - Phone:803-626-0712
Mailing Address - Fax:
Practice Address - Street 1:540 SAINT ANDREWS RD STE 215
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4500
Practice Address - Country:US
Practice Address - Phone:803-626-0712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-30
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty