Integrated Psychological Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0526 Issued in NV

Legal business name

INTEGRATED PSYCHOLOGICAL SERVICES LLC

Practice address

3035 S Maryland Pkwy
Suite 110
Las Vegas, NV 89109-2202

Phone

(702) 751-2547

NPI assigned

Nov 14, 2016

Organization subpart

No

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

Authorized official

Name

Kristi A Walter, PSYD

Title

Sole Member

Phone

(702) 751-2547

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1962944520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82403",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891802403",
            "telephone_number": "702-751-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 S MARYLAND PKWY",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092202",
            "telephone_number": "702-751-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "702-751-2547",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0526",
            "primary": true
        }
    ],
    "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 Nov 14, 2016; 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.