MEDICARE: INTEGRATIVE HEALTH PARTNERS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106H00000X	Marriage & Family Therapist
2	133V00000X	Registered Dietitian
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
4	101YA0400X	Addiction (Substance Use Disorder) Counselor
5	101YP2500X	Professional Counselor
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1770469462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE HEALTH PARTNERS LLC

Provider Business Mailing Address
First Line	:	PO BOX 777447
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89077-7447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2741 W FOND DU LAC AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2624
Country	:	US
Telephone Number	:	833-759-8720
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KANDY MORRIS
Credential	:
Telephone Number	:	833-759-8720

Provider Enumeration Date	:	08/15/2025
Last Update Date	:	08/15/2025

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