Provider Demographics
NPI:1720545650
Name:INTEGRATED PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:INTEGRATED PSYCHOLOGICAL SERVICES LLC
Other - Org Name:LINDA BUSCH SOMACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-408-0407
Mailing Address - Street 1:153 DAKOTA DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-4020
Mailing Address - Country:US
Mailing Address - Phone:718-408-0407
Mailing Address - Fax:973-786-4369
Practice Address - Street 1:37 MAIN ST STE 1067
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1903
Practice Address - Country:US
Practice Address - Phone:718-973-2401
Practice Address - Fax:973-786-4369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty