Provider Demographics
NPI:1457829913
Name:INTEGRATED THERAPY RESOURCES
Entity type:Organization
Organization Name:INTEGRATED THERAPY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARCUM
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:712-986-7800
Mailing Address - Street 1:303A MCKENZIE AVE
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-1014
Mailing Address - Country:US
Mailing Address - Phone:712-986-7800
Mailing Address - Fax:
Practice Address - Street 1:303A MCKENZIE AVE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-1014
Practice Address - Country:US
Practice Address - Phone:712-986-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty