MEDICARE: INVISION INTEGRATED BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	103TP0016X	Prescribing (Medical) Psychologist
5	104100000X	Social Worker
6	1041C0700X	Clinical Social Worker
7	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician
8	2084P0800X	Psychiatry Physician
9	2084P0804X	Child & Adolescent Psychiatry Physician
10	208U00000X	Clinical Pharmacology Physician
11	251S00000X	Community/Behavioral Health Agency
12	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1083159859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INVISION INTEGRATED BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	12450 PERRY HWY
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7387
Country	:	US
Telephone Number	:	724-933-5100
Fax Number	:	724-933-4076

Provider Business Practice Location Address
First Line	:	12450 PERRY HWY
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7387
Country	:	US
Telephone Number	:	724-933-5100
Fax Number	:	724-933-4076

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	KIMBERLY ANN LOVE
Credential	:	MA
Telephone Number	:	724-933-5100

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	01/03/2017

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