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General NPI Number Information
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NPI Number | 1023921921
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHIATRY OF WISCONSIN
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 2453 ATWOOD AVE STE 204
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City | MADISON
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State | WI
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Zip | 53704-5655
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Country | US
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Telephone | 608-516-0759
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Fax | 608-305-8639
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Provider Business Mailing Address
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Address Line | 2722 HOMESTEAD RD
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City | MADISON
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State | WI
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Zip | 53711-4021
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Country | US
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Telephone | 608-516-0759
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Fax | 608-305-8639
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Authorized Official
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Title or Position | OWNER
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Name | SARAH MOORE
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Credential | MD
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Telephone | 608-516-0759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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