| Integrative Wellness, Llc | |
|
610 N Lebanon St Lebanon IN 46052-1716 | |
| (765) 680-0071 | |
| (765) 680-0468 |
| Full Name | Integrative Wellness, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 610 N Lebanon St, Lebanon, Indiana |
| Authorized Official Name and Position | Lynette Clark (MANAGING MEMBER) |
| Authorized Official Contact | 7653664621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Wellness, Llc 610 N Lebanon St Lebanon IN 46052-1716 Ph: (765) 680-0071 | Integrative Wellness, Llc 610 N Lebanon St Lebanon IN 46052-1716 Ph: (765) 680-0071 |
| NPI Number | 1750723490 |
|---|---|
| Provider Enumeration Date | 07/23/2013 |
| Last Update Date | 07/15/2020 |
| Certification Date | 07/15/2020 |
| Medicare PECOS PAC ID | 1951531094 |
|---|---|
| Medicare Enrollment ID | O20140311000881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750723490 | NPI | - | NPPES |
| 20119298A | Medicaid | IN |
| Provider Name | Heather Marie Shelton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821037631 PECOS PAC ID: 8022044940 Enrollment ID: I20050712001070 |
| Provider Name | Crystal L Jones |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356307003 PECOS PAC ID: 5698830784 Enrollment ID: I20090225000110 |
| Provider Name | Anita Kay Parks-gehrung |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508099086 PECOS PAC ID: 1456538123 Enrollment ID: I20110606000467 |
| Provider Name | Donna Renee Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316101363 PECOS PAC ID: 1052580982 Enrollment ID: I20110811000138 |
| Provider Name | Heather Ellen Metzger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750866430 PECOS PAC ID: 3577816586 Enrollment ID: I20181022000805 |
| Provider Name | Kevin Gerard Masterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962881318 PECOS PAC ID: 8921319021 Enrollment ID: I20200717000945 |
| Provider Name | Gabrielle Goldstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871181321 PECOS PAC ID: 0547674590 Enrollment ID: I20210202002571 |
| Provider Name | Amy Elliott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407109671 PECOS PAC ID: 9931518834 Enrollment ID: I20210505001739 |
| Provider Name | Amanda Michelle Christmas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235804261 PECOS PAC ID: 8628474467 Enrollment ID: I20210902002230 |
| Provider Name | Alisha A Fuino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265195424 PECOS PAC ID: 6507255361 Enrollment ID: I20211116002729 |
| Provider Name | Alena Marci Sentir |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396500021 PECOS PAC ID: 3577909191 Enrollment ID: I20240306000885 |
| Provider Name | Jennifer E. Lang |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700287158 PECOS PAC ID: 2365888716 Enrollment ID: I20240308000206 |
| Provider Name | Leah J Freeland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407824055 PECOS PAC ID: 0547606881 Enrollment ID: I20240309000158 |
| Provider Name | Christopher G Christmas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932415973 PECOS PAC ID: 8123402633 Enrollment ID: I20240314001685 |
| Provider Name | Kaitlin Renee Faust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235914755 PECOS PAC ID: 6103262829 Enrollment ID: I20240315001847 |
| Provider Name | Elaine Ilene Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841054632 PECOS PAC ID: 3375981343 Enrollment ID: I20240410000530 |
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