Provider Demographics
NPI:1639521305
Name:INTEGRATED INDIVIDUAL AND FAMILY THERAPY, LLC
Entity Type:Organization
Organization Name:INTEGRATED INDIVIDUAL AND FAMILY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAREEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-238-4509
Mailing Address - Street 1:25 DAY SCHOOL DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06455-1276
Mailing Address - Country:US
Mailing Address - Phone:475-238-4509
Mailing Address - Fax:
Practice Address - Street 1:25 DAY SCHOOL DR
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06455-1276
Practice Address - Country:US
Practice Address - Phone:475-238-4509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional