Integration Mental Health LLC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

130627 Issued in CO

Legal business name

INTEGRATION MENTAL HEALTH LLC

Practice address

1919 65TH Ave Ste C
Greeley, CO 80634-7965

Phone

(970) 590-1138

NPI assigned

Nov 11, 2015

Last updated

Aug 2, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan PonderNPI 1336496330

Title

Owner

Phone

(970) 590-1138

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Jo Ponder, RN, CNS/RXN

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Greeley, CO
  • NPI 1336496330
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1134592256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 65TH AVE STE C",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 65TH AVE STE C",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347965",
            "telephone_number": "970-590-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATION MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "PONDER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-590-1138"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CO",
            "license": "130627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Greeley, CO
• Providers in Greeley, CO by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.