MEDICARE: INTEGRATION COUNSELING

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	:	1912730813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATION COUNSELING

Provider Business Mailing Address
First Line	:	14701 DETROIT AVE STE 587
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14701 DETROIT AVE STE 587
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4115
Country	:	US
Telephone Number	:	440-708-8922
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARY KAY SHELTON
Credential	:	LPCC
Telephone Number	:	440-708-8922

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	01/02/2026

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Directions to “INTEGRATION COUNSELING ” Practice Location

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