MEDICARE: INTEGRATIVE MENTAL HEALTH SOLUTIONS, PLLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1891548491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE MENTAL HEALTH SOLUTIONS, PLLC

Provider Business Mailing Address
First Line	:	16710 STONESIDE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-6514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16710 STONESIDE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-6514
Country	:	US
Telephone Number	:	832-464-5131
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JEREMY SPROTT
Credential	:	LPC-S
Telephone Number	:	832-464-5131

Provider Enumeration Date	:	04/11/2024
Last Update Date	:	04/26/2024

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