Provider Demographics
NPI:1861499410
Name:INTEGRATIVE PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:INTEGRATIVE PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:ZUESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-787-4420
Mailing Address - Street 1:4835 E CACTUS RD
Mailing Address - Street 2:STE 335
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3542
Mailing Address - Country:US
Mailing Address - Phone:602-787-4420
Mailing Address - Fax:602-787-4419
Practice Address - Street 1:4835 E CACTUS RD
Practice Address - Street 2:STE 335
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3542
Practice Address - Country:US
Practice Address - Phone:602-787-4420
Practice Address - Fax:602-787-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ291892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0753970OtherBCBS NON-CONTRACTED ID#
AZ287281OtherHEALTHNET
AZ2112791OtherCIGNA
AZ5428190OtherAFFORDABLE FIRST HEALTH
AZ594970Medicaid
H43677Medicare UPIN
AZ2112791OtherCIGNA