MEDICARE: INTEGRAL GROWTH SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1821805417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRAL GROWTH SOLUTIONS

Provider Business Mailing Address
First Line	:	4509 BUFFALO BEND PL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-6158
Country	:	US
Telephone Number	:	682-730-6634
Fax Number	:

Provider Business Practice Location Address
First Line	:	4509 BUFFALO BEND PL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-6158
Country	:	US
Telephone Number	:	682-730-6634
Fax Number	:

Authorized Official
Title or Position	:	OWNER / THERAPIST
Name	:	PATRICK RAMSEY
Credential	:	LPC-S
Telephone Number	:	682-730-6634

Provider Enumeration Date	:	12/17/2024
Last Update Date	:	12/17/2024

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