MEDICARE: INTEGRATED GROWTH THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1003616178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED GROWTH THERAPY LLC

Provider Business Mailing Address
First Line	:	9015 W UNION HILLS DR STE 107 #623
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-3106
Country	:	US
Telephone Number	:	619-678-2268
Fax Number	:

Provider Business Practice Location Address
First Line	:	9015 W UNION HILLS DR STE 107 #623
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-3106
Country	:	US
Telephone Number	:	619-678-2268
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST AND OWNER
Name	:	LAUREN HOOVER
Credential	:	LMFT
Telephone Number	:	619-678-2268

Provider Enumeration Date	:	03/17/2025
Last Update Date	:	03/17/2025

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