Provider Demographics
NPI:1558162073
Name:INTEGRATED LIFEPSYCH SERVICES, LLC
Entity type:Organization
Organization Name:INTEGRATED LIFEPSYCH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPE-I
Authorized Official - Phone:501-992-6467
Mailing Address - Street 1:PO BOX 6138
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72124-6138
Mailing Address - Country:US
Mailing Address - Phone:501-992-6467
Mailing Address - Fax:501-214-6871
Practice Address - Street 1:7512 HIGHWAY 107
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-4645
Practice Address - Country:US
Practice Address - Phone:501-992-6467
Practice Address - Fax:501-214-6871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty