Krueger Integrative Care, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

KRUEGER INTEGRATIVE CARE, LLC

Practice address

4893 Prince William Pkwy
Woodbridge, VA 22192-5403

Phone

(850) 565-9710

NPI assigned

May 28, 2019

Last updated

May 28, 2019By 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

Dr. Tonice Krueger, LCPNPI 1184949398

Title

Licenced Psychologist, Director

Phone

(619) 865-9399

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

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.

• Tonice Krueger, LP

  • Clinical Psychologist
  • Niceville, FL
  • NPI 1184949398
  Medicare reassignment NPD Authorized official
• Kelly A Kugler, LMHC

  • Mental Health Counselor
  • Panama City, FL
  • NPI 1043653421
  Medicare reassignment NPD
• Lindsey Robin Christian, LCSW

  • Mental Health Counselor
  • Niceville, FL
  • NPI 1235888736
  NPD
• Alexious Milord, MSW

  • Clinical Social Worker
  • Niceville, FL
  • NPI 1245038124
  NPD
• Michelle Renee Pettit, LCSW

  • Clinical Social Worker
  • Eglin AFB, FL
  • NPI 1750824488
  NPD

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1174180822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4467 NEW MARKET RD",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325784915",
            "telephone_number": "619-865-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4893 PRINCE WILLIAM PKWY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925403",
            "telephone_number": "850-565-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRUEGER INTEGRATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "TONICE",
        "authorized_official_title_or_position": "LICENCED PSYCHOLOGIST, DIRECTOR",
        "authorized_official_telephone_number": "619-865-9399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1184949398",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Gayle Kovach
• Elaine Sue Kramer, PH.D
• Megan L Krenz, MSW
• Krishnan S. Kumar, M.D., P.C.
• Alyssa Kroll
• Diana Rachel Kuhl-Chapman, MSW
• Ajay Kumar, M.D
• Leticia Kusi, NP
• Brandy Laine Kuzins, MA, LPC
• Eugenia Mawufenya Kwa-Kofi, APRN

• Adult Mental Health Clinic/Center in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Adult Mental Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.