Provider Demographics
NPI:1700290434
Name:INTEGRATIVE COUNSELING SOLUTIONS LLC
Entity Type:Organization
Organization Name:INTEGRATIVE COUNSELING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:FRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LOC
Authorized Official - Phone:970-216-1740
Mailing Address - Street 1:326 MAIN ST.
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1862
Mailing Address - Country:US
Mailing Address - Phone:970-216-1740
Mailing Address - Fax:
Practice Address - Street 1:326 MAIN ST
Practice Address - Street 2:SUITE 209
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1869
Practice Address - Country:US
Practice Address - Phone:970-216-1740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO222251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health