Healthcare Provider Details

I. General information

NPI: 1538083514
Provider Name (Legal Business Name): ADAPTIVE INTEGRATIVE THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 8TH ST STE 110
VANCOUVER WA
98660-3294
US

IV. Provider business mailing address

101 E 8TH ST STE 110
VANCOUVER WA
98660-3294
US

V. Phone/Fax

Practice location:
  • Phone: 360-245-2652
  • Fax:
Mailing address:
  • Phone:
  • 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: ANDREA SANTA MARIA
Title or Position: PSYCHOTHERAPIST, CEO
Credential: PHD, LMCHA, NCC
Phone: 360-245-2652