Basic Information
| Provider Information | |||||||||
| NPI: | 1841797941 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTEGRATED COUNSELING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2311 E STADIUM BLVD STE B5 | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481044803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345319839 | ||||||||
| FaxNumber: | 7342075326 | ||||||||
| Practice Location | |||||||||
| Address1: | 2311 E STADIUM BLVD STE B5 | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481044803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345319839 | ||||||||
| FaxNumber: | 7342075326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2018 | ||||||||
| LastUpdateDate: | 04/06/2018 | ||||||||
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| AuthorizedOfficialLastName: | RANSLEY | ||||||||
| AuthorizedOfficialFirstName: | HUGH | ||||||||
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| AuthorizedOfficialTitleorPosition: | LLP / OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7345319839 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 6301013361 | MI | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.