Provider Demographics
NPI:1114713773
Name:INTEGRATED SELF PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:INTEGRATED SELF PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOHL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-942-5586
Mailing Address - Street 1:27129 HASS ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2809
Mailing Address - Country:US
Mailing Address - Phone:313-942-5586
Mailing Address - Fax:
Practice Address - Street 1:2002 HOGBACK RD STE 10
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9736
Practice Address - Country:US
Practice Address - Phone:313-942-5586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty