Healthcare Provider Details

I. General information

NPI: 1700538014
Provider Name (Legal Business Name): INTEGRO COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 S BOYD ST STE 100
WINTER GARDEN FL
34787-3574
US

IV. Provider business mailing address

161 S BOYD ST STE 100
WINTER GARDEN FL
34787-3574
US

V. Phone/Fax

Practice location:
  • Phone: 407-392-2828
  • Fax:
Mailing address:
  • Phone: 407-392-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DARREN M LOWE
Title or Position: OWNER/COUNSELOR
Credential: MA, LMHC
Phone: 407-392-2828