| Integrum Psychotherapy, Llc | |
|
1174 E Graystone Way Ste 6 Salt Lake City UT 84106-2671 | |
| (801) 683-5330 | |
| Not Available |
| Full Name | Integrum Psychotherapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1174 E Graystone Way Ste 6, Salt Lake City, Utah |
| Authorized Official Name and Position | Ryan Walter Morgan (OWNER) |
| Authorized Official Contact | 2024875244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrum Psychotherapy, Llc 1584 E Glen Arbor St Salt Lake City UT 84105-3813 Ph: (919) 949-0486 | Integrum Psychotherapy, Llc 1174 E Graystone Way Ste 6 Salt Lake City UT 84106-2671 Ph: (801) 683-5330 |
| NPI Number | 1619455714 |
|---|---|
| Provider Enumeration Date | 07/31/2018 |
| Last Update Date | 07/31/2018 |
| Medicare PECOS PAC ID | 3577811611 |
|---|---|
| Medicare Enrollment ID | O20180806001252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619455714 | NPI | - | NPPES |
| 1114242724 | Other | NPI | |
| 1518211705 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Abigail Zeveloff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518211705 PECOS PAC ID: 7719275619 Enrollment ID: I20161010000453 |
| Provider Name | Ryan W Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114242724 PECOS PAC ID: 0143493551 Enrollment ID: I20180806001348 |
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