Integral Psychotherapy, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4807 Issued in MN

Legal business name

INTEGRAL PSYCHOTHERAPY, LLC

Practice address

3808 Grand Ave S
Minneapolis, MN 55409-1233

Phone

(612) 807-0388

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Gustaf Thompson, PSY.D.NPI 1649481870

Title

Owner

Phone

(612) 807-0388

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 6

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

• David G Thompson, PSYD., LP

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1649481870
  Medicare reassignment NPD Authorized official
• Clare Rubin, MA

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1114621059
  NPD
• Jihan Saba

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1427725472
  NPD
• Lane Holden, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1962321067
  NPD (past)
• Arthur Jay Lebow, PH.D.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1265509780
  NPD (past)
• Cody Lewis Oaks, MA, LPCC

  • Counselor
  • Minneapolis, MN
  • NPI 1023592904
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322179200000",
    "number": "1376768853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 GRAND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091233",
            "telephone_number": "612-807-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 GRAND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091233",
            "telephone_number": "612-807-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-11-25",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GUSTAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-807-0388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2011; 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.