Integrated Psychological Services Llc | |
413 Broadway St Unit A Paducah KY 42001-0738 | |
(618) 727-1913 | |
Not Available |
Full Name | Integrated Psychological Services Llc |
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Speciality | Psychologist |
Location | 413 Broadway St Unit A, Paducah, Kentucky |
Authorized Official Name and Position | Ashton Briauna Shelby (OWNER/PSYCHOLOGIST) |
Authorized Official Contact | 6187271913 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integrated Psychological Services Llc 413 Broadway St Unit A Paducah KY 42001-0738 Ph: () - | Integrated Psychological Services Llc 413 Broadway St Unit A Paducah KY 42001-0738 Ph: (618) 727-1913 |
NPI Number | 1063163442 |
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Provider Enumeration Date | 01/17/2022 |
Last Update Date | 01/17/2022 |
Certification Date | 01/17/2022 |
Medicare PECOS PAC ID | 0749651180 |
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Medicare Enrollment ID | O20230124000521 |
Identifier | Type | State | Issuer |
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1063163442 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Ashton Briauna Shelby |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1881219319 PECOS PAC ID: 1658742093 Enrollment ID: I20230124000659 |
Provider Name | Lauren Barks |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1033820774 PECOS PAC ID: 4385016500 Enrollment ID: I20230215002357 |
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