Provider Demographics
NPI:1700538014
Name:INTEGRO COUNSELING, LLC
Entity Type:Organization
Organization Name:INTEGRO COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:407-392-2828
Mailing Address - Street 1:161 S BOYD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3574
Mailing Address - Country:US
Mailing Address - Phone:407-392-2828
Mailing Address - Fax:
Practice Address - Street 1:161 S BOYD ST STE 100
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3574
Practice Address - Country:US
Practice Address - Phone:407-392-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1275297848OtherINDIVIDUAL
FL1831768902OtherINDIVIDUAL