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General NPI Number Information
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NPI Number | 1134587017
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHOLOGICAL HEALTH, LLC
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 26777 LORAIN RD STE 412
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-3224
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Country | US
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Telephone | 216-801-4656
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Fax | 216-767-5900
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Provider Business Mailing Address
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Address Line | 26777 LORAIN RD STE 412
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-3224
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Country | US
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Telephone | 216-801-4656
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Fax | 216-767-5900
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ADRIANA FAUR
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Credential | PH.D.
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Telephone | 440-915-6515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 6890
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 6890
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License Number State | OH
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