# INTEGRATIVE COUNSELING PRACTICES

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

## Provider details

- **NPI number:** 1376153106
- **Authorized official:** GINA LEA STORK LMHC (MEMBER)
- **Authorized official phone:** (712) 790-9318

## Contact information

- **Practice address:** 1728 CENTRAL AVE STE 10, FORT DODGE, IA 50501-4200
- **Practice address phone:** (712) 790-9318
- **Practice address fax:** (515) 598-8545
- **Mailing address:** 3662 GARBER AVE, LAKE CITY, IA 51449-7554
- **Mailing address phone:** (712) 790-9318

## Taxonomy

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

## Other

- **Enumeration date:** 08/06/2020
- **Last updated:** 08/31/2020