# INTEGRATED PSYCHOLOGICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063163442
- **Authorized official:** ASHTON BRIAUNA SHELBY PHD, LP (OWNER/PSYCHOLOGIST)
- **Authorized official phone:** (618) 727-1913

## Contact information

- **Practice address:** 413 BROADWAY ST UNIT A, PADUCAH, KY 42001-0738
- **Practice address phone:** (618) 727-1913
- **Mailing address:** 413 BROADWAY ST UNIT A, PADUCAH, KY 42001-0738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2022
- **Last updated:** 01/17/2022