Provider Demographics
NPI:1659997237
Name:INTEGRATIVE COUNSELING SERVICES
Entity Type:Organization
Organization Name:INTEGRATIVE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:BRAINARD
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPCC
Authorized Official - Phone:440-570-2541
Mailing Address - Street 1:124 LAFAYETTE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2378
Mailing Address - Country:US
Mailing Address - Phone:440-570-2541
Mailing Address - Fax:
Practice Address - Street 1:124 LAFAYETTE RD STE 200
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2378
Practice Address - Country:US
Practice Address - Phone:440-570-2541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty