Provider Demographics
NPI:1497308639
Name:LOVESTRONG INTEGRATIVE SERVICES, LLC
Entity Type:Organization
Organization Name:LOVESTRONG INTEGRATIVE SERVICES, LLC
Other - Org Name:LOVESTRONG INTEGRATIVE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:A L
Authorized Official - Last Name:LEUTSCHAFT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:507-475-4353
Mailing Address - Street 1:1560 DEER TRAIL LN NE
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2096
Mailing Address - Country:US
Mailing Address - Phone:507-475-4353
Mailing Address - Fax:
Practice Address - Street 1:1560 DEER TRAIL LN NE
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-2096
Practice Address - Country:US
Practice Address - Phone:317-743-5539
Practice Address - Fax:972-323-8640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty