Provider Demographics
NPI:1063202588
Name:SUMMIT INTEGRATIVE MINDCARE PLLC
Entity type:Organization
Organization Name:SUMMIT INTEGRATIVE MINDCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OI KI HEDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP
Authorized Official - Phone:310-866-1880
Mailing Address - Street 1:15200 E GIRARD AVE STE 2500
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5005
Mailing Address - Country:US
Mailing Address - Phone:720-856-0300
Mailing Address - Fax:720-844-3303
Practice Address - Street 1:15200 E GIRARD AVE STE 2500
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5005
Practice Address - Country:US
Practice Address - Phone:720-856-0300
Practice Address - Fax:720-844-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty