Healthcare Provider Details
I. General information
NPI: 1013716034
Provider Name (Legal Business Name): INTEGRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/11/2025
Last Update Date: 03/22/2025
Certification Date: 03/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6801 JEFFERSON ST NE STE 301
ALBUQUERQUE NM
87109-7390
US
IV. Provider business mailing address
5720 EL PRADO RD NW
LOS RANCHOS NM
87107-6310
US
V. Phone/Fax
- Phone: 505-600-1808
- Fax: 505-636-9971
- Phone: 505-600-1808
- Fax: 505-636-9971
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
WOOD
Title or Position: OWNER
Credential: LCSW
Phone: 505-977-2007