INTEGRATIVE MIND BODY THERAPY LLC NPI 1407594153

NPI Information

  • NPI: 1407594153
  • Provider Name: INTEGRATIVE MIND BODY THERAPY, LLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 2511 STADIUM DR
    CHARLESTON, SC
    ZIP 29406
  • Phone: (816) 752-6631

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NPI Details

INTEGRATIVE MIND BODY THERAPY, LLC is a professional counselor in Charleston, SC. INTEGRATIVE MIND BODY THERAPY, LLC NPI is 1407594153. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2511 STADIUM DR
CHARLESTON, SC
ZIP 29406-606
Phone: (816) 752-6631
Fax: (844) 919-1630

The provider's authorized official is Lisa Fracica .
The authorized official title is Owner And Sole Member and has the following contact phone number (816) 752-6631.

The enumeration date for this NPI number is 5/23/2022 and was last updated on 11/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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