Provider Demographics
NPI:1184807299
Name:INTEGRATIVE EDUCATIONAL PARTNERS, LLC
Entity type:Organization
Organization Name:INTEGRATIVE EDUCATIONAL PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BILLETT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:616-874-7490
Mailing Address - Street 1:6739 COURTLAND DR NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-7216
Mailing Address - Country:US
Mailing Address - Phone:616-874-7490
Mailing Address - Fax:847-770-4772
Practice Address - Street 1:6739 COURTLAND DR NE
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-7216
Practice Address - Country:US
Practice Address - Phone:616-874-7490
Practice Address - Fax:847-770-4772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI363LP0808X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty