Healthcare Provider Details
I. General information
NPI: 1992178230
Provider Name (Legal Business Name): INTEGRATED THERAPEUTIC SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2015
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6549 FREEPORT DR
SPRING HILL FL
34608-1208
US
IV. Provider business mailing address
6549 FREEPORT DR
SPRING HILL FL
34608-1208
US
V. Phone/Fax
- Phone: 678-722-1031
- Fax: 470-297-3660
- Phone: 678-722-1031
- Fax: 470-297-3660
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 8573 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 5279 |
| License Number State | GA |
VIII. Authorized Official
Name:
ANNALEIGHA
MORIARTY
Title or Position: OWNER/CLINICAL SUPERVISOR
Credential: MPS, LPC, LMHC, CPCS
Phone: 678-722-1031