Integrated Behavioral Wellness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

052946 Issued in NY

Legal business name

INTEGRATED BEHAVIORAL WELLNESS, LLC

Practice address

2 Fountain St
Ste 110
Clinton, NY 13323-1725

Phone

(315) 381-3101

NPI assigned

Sep 14, 2007

Organization subpart

No

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

Authorized official

Name

James E Klein

Title

Director

Phone

(315) 381-3101

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1366637167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GATES RD",
            "address_2": "STE 3",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502288",
            "telephone_number": "607-772-9462",
            "fax_number": "607-772-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FOUNTAIN ST",
            "address_2": "STE 110",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231725",
            "telephone_number": "315-381-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED BEHAVIORAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "315-381-3101"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "052946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary A Hosey-Pardi
• Tina Alice Hoyt, CCC-SLP
• Emma Hutchens
• Jillian Lee Iacovissi
• Innovative Services Inc
• Cheyenne Isaacs, RDN
• J Michel Associate
• Angela Marie Jaros, PHARMD
• Jean M Baker
• Jennie Mazza Jones LCSW PLLC

• Clinical Social Worker in Clinton, NY
• Providers in Clinton, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.