Healthcare Provider Details

I. General information

NPI: 1346022563
Provider Name (Legal Business Name): INTEGRATED HEALTHCARE ADVISORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8428 S 16TH DR
PHOENIX AZ
85041-6908
US

IV. Provider business mailing address

PO BOX 8477
PHOENIX AZ
85066-8477
US

V. Phone/Fax

Practice location:
  • Phone: 602-635-0885
  • Fax:
Mailing address:
  • Phone: 602-935-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL R HEDDEN
Title or Position: OWNER
Credential: LPC
Phone: 602-935-5110