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General NPI Number Information
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NPI Number | 1457275943
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHODYNAMICS LLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 503 OLD PLANTATION DR
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City | LYNCHBURG
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State | VA
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Zip | 24502-6963
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Country | US
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Telephone | 434-515-0423
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Fax |
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Provider Business Mailing Address
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Address Line | 3823 MOORMAN DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-3133
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | AUSTIN NELSON
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Credential |
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Telephone | 434-515-0423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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