# INTEGRATED MIND PSYCHOTHERAPY PLLC

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

## Provider details

- **NPI number:** 1245959410
- **Authorized official:** SARA M MCCULLOUGH LCSW (OWNER)
- **Authorized official phone:** (757) 663-2660

## Contact information

- **Practice address:** 5705 LYNNHAVEN PKWY STE 104-1074, VIRGINIA BEACH, VA 23464-9152
- **Practice address phone:** (757) 663-2660
- **Mailing address:** 2005 RAMSAY CT, VIRGINIA BEACH, VA 23464-9000
- **Mailing address phone:** (757) 663-2660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2022
- **Last updated:** 08/23/2022