Provider Demographics
NPI:1285783357
Name:INTEGRATIVE TRAINING & CONSULTING, LLC
Entity type:Organization
Organization Name:INTEGRATIVE TRAINING & CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCHERZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-304-4624
Mailing Address - Street 1:108 FAIRWAY TER
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2321
Mailing Address - Country:US
Mailing Address - Phone:609-304-4624
Mailing Address - Fax:
Practice Address - Street 1:108 FAIRWAY TER
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2321
Practice Address - Country:US
Practice Address - Phone:609-304-4624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00242600101Y00000X
NJ37PC00320500101YP2500X
NJ35SI00379400103T00000X
NJ35S100489500103TC0700X
NJ44SC048304001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2101101000OtherINDEPENDENCE BC
PA2101101000OtherINDEPENDENCE BLUE CROSS