NPIMap

Organization Active NPI

Integral Psychology Center

  • Mental Health Counselor
  • Madison, WI
National Provider Identifier
1366481749
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1914 Issued in WI
Legal business name
INTEGRAL PSYCHOLOGY CENTER
Practice address
1619 Monroe St
Madison, WI 53711-2063
Phone
(608) 255-9330
Fax
(608) 255-7810
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dennis Merritt, L.C.S.W, PH.DNPI 1851456842
Title
President
Phone
(608) 255-9330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 1914 WI Primary

Addresses

Primary practice location

1619 Monroe St
Madison, WI 53711-2063

Mailing address

1619 Monroe St
Madison, WI 53711-2063
Phone (608) 255-9330

Other identifiers 1

IdentifierTypeStateIssuer
42162900MedicaidWI

Other names 1

  • The Integral Psychology Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070418000320 WI Part B Supplier - Clinic/Group Practice 7810092996 Receives reassigned benefits from 5 practitioners
Practice locations: Madison, WI

National Provider Directory

National Provider Directory

Locations

1619 Monroe St
Madison, WI 53711
Phone (608) 255-9330

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366481749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL PSYCHOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-255-9330",
        "authorized_official_credential": "L.C.S.W, PH.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42162900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Integral Psychology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.