Provider Demographics
NPI:1730557109
Name:INTEGRATIVE PSYCHOTHERAPY SERVICES OF SAN DIEGO, INC.
Entity type:Organization
Organization Name:INTEGRATIVE PSYCHOTHERAPY SERVICES OF SAN DIEGO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORPEY-NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:720-445-9468
Mailing Address - Street 1:9233 PARK MEADOWS DR STE 227
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5426
Mailing Address - Country:US
Mailing Address - Phone:720-445-9468
Mailing Address - Fax:720-210-9777
Practice Address - Street 1:9233 PARK MEADOWS DR STE 227
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5426
Practice Address - Country:US
Practice Address - Phone:720-445-9468
Practice Address - Fax:720-210-9777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24375103TC0700X
CAPSY 25968103TC2200X
CAPSY 27289103TC2200X
CAPSY24358103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty