Provider Demographics
NPI:1932550027
Name:INTEGRATIVE PSYCHOLOGY GROUP LLC
Entity Type:Organization
Organization Name:INTEGRATIVE PSYCHOLOGY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ZAMPITELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:302-307-3702
Mailing Address - Street 1:300 CREEK VIEW RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-8546
Mailing Address - Country:US
Mailing Address - Phone:302-307-3702
Mailing Address - Fax:302-355-3400
Practice Address - Street 1:300 CREEK VIEW RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-8546
Practice Address - Country:US
Practice Address - Phone:302-307-3702
Practice Address - Fax:302-355-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0001010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty