Organization Active NPI

Integrative Mind & Body Wellness LLC

  • Marriage & Family Therapist
  • Castle Rock, CO
National Provider Identifier
1942002340
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
INTEGRATIVE MIND & BODY WELLNESS LLC
Practice address
801 S Perry St Ste 115
Castle Rock, CO 80104-1986
Phone
(970) 219-9089
NPI assigned
Mar 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Mr. Dustin M Holcomb, BCBA, BCN, BCBNPI 1851690002
Title
Owner
Phone
(970) 219-9089

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

801 S Perry St Ste 115
Castle Rock, CO 80104-1986

Mailing address

801 S Perry St Ste 115
Castle Rock, CO 80104-1986
Phone (970) 219-9089

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250603002204 CO Part B Supplier - Clinic/Group Practice 3971012758 Receives reassigned benefits from 2 practitioners
Practice locations: Castle Rock, CO

National Provider Directory

National Provider Directory

Locations

801 S Perry St
Ste 115
Castle Rock, CO 80104
Phone (970) 219-9089

Practitioners & affiliated clinicians

Practitioners 2

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": "1742947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1942002340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S PERRY ST STE 115",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041986",
            "telephone_number": "970-219-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PERRY ST STE 115",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041986",
            "telephone_number": "970-219-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MIND & BODY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "HOLCOMB",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-219-9089",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCBA, BCN, BCB"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.