Provider Demographics
NPI:1770379406
Name:INTEGRATIVE MENTAL HEALTH
Entity type:Organization
Organization Name:INTEGRATIVE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-871-0217
Mailing Address - Street 1:91 MEADOWS EDGE
Mailing Address - Street 2:
Mailing Address - City:STARKSBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05487-7360
Mailing Address - Country:US
Mailing Address - Phone:802-871-0217
Mailing Address - Fax:
Practice Address - Street 1:91 MEADOWS EDGE
Practice Address - Street 2:
Practice Address - City:STARKSBORO
Practice Address - State:VT
Practice Address - Zip Code:05487-7360
Practice Address - Country:US
Practice Address - Phone:802-871-0217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty