Integrative Therapy Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INTEGRATIVE THERAPY CENTER LLC

Practice address

242 W 30TH St RM 602
New York, NY 10001-4954

Phone

(917) 268-9213

NPI assigned

Jul 15, 2020

Organization subpart

No

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

Authorized official

Name

Juan Jose Robles Gil Aleman

Title

Owner

Phone

(617) 784-4246

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1669080610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 W 30TH ST RM 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014954",
            "telephone_number": "917-268-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 W 30TH ST RM 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014954",
            "telephone_number": "917-268-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "ROBLES GIL ALEMAN",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-784-4246"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.