MEDICARE: IG THERAPEUTIC SERVICES 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1104764448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IG THERAPEUTIC SERVICES LLC

Provider Business Mailing Address
First Line	:	8360 W OAKLAND PARK BLVD STE 205
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-7332
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8360 W OAKLAND PARK BLVD STE 205
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-7332
Country	:	US
Telephone Number	:	813-720-8559
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	IESHY GALES
Credential	:	LMHC
Telephone Number	:	323-345-7460

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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Directions to “IG THERAPEUTIC SERVICES LLC ” Practice Location

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