Healthcare Provider Details

I. General information

NPI: 1174353569
Provider Name (Legal Business Name): INTEGRATED HEALING PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S LIVINGSTON AVE STE 205
LIVINGSTON NJ
07039-3929
US

IV. Provider business mailing address

6 SUMMIT ST APT 107
WEST ORANGE NJ
07052-1509
US

V. Phone/Fax

Practice location:
  • Phone: 973-440-9963
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: YU EN CHIU
Title or Position: OWNER
Credential: LPC, LPAT
Phone: 973-440-9963