Provider Demographics
NPI:1053833566
Name:INTEGRATED HEALTH CLINICAL COUNSELING P.L.L.C.
Entity type:Organization
Organization Name:INTEGRATED HEALTH CLINICAL COUNSELING P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-720-9782
Mailing Address - Street 1:90 FORT WADE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-5114
Mailing Address - Country:US
Mailing Address - Phone:734-787-2183
Mailing Address - Fax:734-571-6888
Practice Address - Street 1:90 FORT WADE RD STE 100
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-5114
Practice Address - Country:US
Practice Address - Phone:734-720-9782
Practice Address - Fax:734-571-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health