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General NPI Number Information
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NPI Number | 1639970221
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE THERAPY, LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 4750 VENTURE DR STE 400
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City | ANN ARBOR
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State | MI
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Zip | 48108-9505
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Country | US
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Telephone | 313-666-7742
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Fax |
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Provider Business Mailing Address
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Address Line | 2135 HOLLOW OAK DR
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City | ANN ARBOR
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State | MI
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Zip | 48103-8402
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Country | US
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Telephone | 646-660-3713
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Fax |
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Authorized Official
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Title or Position | LICENSED MASTER SOCIAL WORKER
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Name | BRIAN KELLEY
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Credential | LMSW, CAADC
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Telephone | 313-666-7742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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