Healthcare Provider Details

I. General information

NPI: 1053297747
Provider Name (Legal Business Name): INTEGRATIVE HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 03/15/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 ARIZONA ST
CLOVIS NM
88101-2110
US

IV. Provider business mailing address

PO BOX 401477
LAS VEGAS NV
89140-1477
US

V. Phone/Fax

Practice location:
  • Phone: 888-343-6046
  • Fax: 888-343-6746
Mailing address:
  • Phone: 888-343-6046
  • Fax: 888-343-6046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KANDY MORRIS
Title or Position: CEO
Credential:
Phone: 833-759-8720