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General NPI Number Information
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NPI Number | 1043802663
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Entity Type | Organization
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Legal Business Name | INTEGRAL THERAPY INC.
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 5133 WASHINGTON ST STE 11
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4795
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Country | US
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Telephone | 630-398-1023
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Fax |
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Provider Business Mailing Address
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Address Line | 5133 WASHINGTON ST STE 6
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4757
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Country | US
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Telephone | 630-398-1023
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Fax |
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Authorized Official
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Title or Position | LCSW/OWNER
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Name | STACEY SANICKI
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Credential | LCSW
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Telephone | 630-398-1023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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