Provider Demographics
NPI:1063300481
Name:INTEGRAL ALCHEMY PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:INTEGRAL ALCHEMY PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:541-228-7882
Mailing Address - Street 1:590 PEARL ST STE 109
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2780
Mailing Address - Country:US
Mailing Address - Phone:541-228-7882
Mailing Address - Fax:541-249-7788
Practice Address - Street 1:590 PEARL ST STE 109
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2780
Practice Address - Country:US
Practice Address - Phone:541-228-7882
Practice Address - Fax:541-249-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty