Provider Demographics
NPI:1437971207
Name:INTEGRATIVE BEHAVIORAL THERAPIES
Entity type:Organization
Organization Name:INTEGRATIVE BEHAVIORAL THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LANDOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LAC
Authorized Official - Phone:970-261-5254
Mailing Address - Street 1:2664 SACOMA CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JCT
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1834
Mailing Address - Country:US
Mailing Address - Phone:970-261-5254
Mailing Address - Fax:
Practice Address - Street 1:2664 SACOMA CT
Practice Address - Street 2:
Practice Address - City:GRAND JCT
Practice Address - State:CO
Practice Address - Zip Code:81506-1834
Practice Address - Country:US
Practice Address - Phone:970-261-5254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty