Provider Demographics
NPI:1245513894
Name:INTEGRATED THERAPY SERVICES INC.
Entity type:Organization
Organization Name:INTEGRATED THERAPY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT (CEO)
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:CHERYL
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP-CCC, BCBA
Authorized Official - Phone:805-484-1671
Mailing Address - Street 1:150 VALLEY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1725
Mailing Address - Country:US
Mailing Address - Phone:805-484-1671
Mailing Address - Fax:805-987-0667
Practice Address - Street 1:150 VALLEY VISTA DR
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1725
Practice Address - Country:US
Practice Address - Phone:805-484-1671
Practice Address - Fax:805-987-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP3002235Z00000X, 252Y00000X
CALEP2570103TS0200X
CA1-11-8110103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ83857ZOtherBLUE OF CALIFORNIA