MEDICARE: INTEGRATIVE PSYCHOLOGY 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	103TC0700X	Clinical Psychologist	PY8234	FL

General Provider Information

NPI Number	:	1215220900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE PSYCHOLOGY LLC

Provider Business Mailing Address
First Line	:	616 NE FRANCESCA LN
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33487-5210
Country	:	US
Telephone Number	:	561-859-6767
Fax Number	:	561-637-8210

Provider Business Practice Location Address
First Line	:	550 SE 6TH AVE # 200K
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5306
Country	:	US
Telephone Number	:	561-859-6767
Fax Number	:	561-637-8754

Authorized Official
Title or Position	:	LICENSED CLINICAL PSYCHOLOGIST
Name	:	DR. CARYL A. KEATING
Credential	:	PSY.D.
Telephone Number	:	561-859-6767

Provider Enumeration Date	:	05/27/2011
Last Update Date	:	04/07/2025

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