| Integrated Psychological Services Llc | |
|
2631 Nw 41st St Ste E5 Gainesville FL 32606-6689 | |
| (808) 747-5435 | |
| (866) 384-4779 |
| Full Name | Integrated Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2631 Nw 41st St Ste E5, Gainesville, Florida |
| Authorized Official Name and Position | Jeffrey Gedney (OWNER) |
| Authorized Official Contact | 8087475435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Psychological Services Llc Po Box 358742 Gainesville FL 32635-8742 Ph: (808) 747-5435 | Integrated Psychological Services Llc 2631 Nw 41st St Ste E5 Gainesville FL 32606-6689 Ph: (808) 747-5435 |
| NPI Number | 1790964807 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 03/10/2014 |
| Medicare PECOS PAC ID | 4587670922 |
|---|---|
| Medicare Enrollment ID | O20060222000705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790964807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY6767 (Florida) | Primary |
| Provider Name | Courtney D Stahl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043250525 PECOS PAC ID: 8729158613 Enrollment ID: I20080604000288 |
| Provider Name | Jane E Echterling |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1174734073 PECOS PAC ID: 6800014333 Enrollment ID: I20140826000763 |
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