Provider Demographics
NPI:1386482453
Name:INVICTUS MIND-BODY INTEGRATION THERAPY PLLC
Entity type:Organization
Organization Name:INVICTUS MIND-BODY INTEGRATION THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZZI
Authorized Official - Middle Name:VARGA
Authorized Official - Last Name:REINARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:423-597-2688
Mailing Address - Street 1:189 E US HIGHWAY 40 STE D
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-2267
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:189 E US HIGHWAY 40 STE D
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:IL
Practice Address - Zip Code:62294-2267
Practice Address - Country:US
Practice Address - Phone:423-597-2688
Practice Address - Fax:618-505-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty