# INTEGRATIVE THERAPY, LLC

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

## Provider details

- **NPI number:** 1558698282
- **Authorized official:** CAROLYN BURNS LMFT (PROPRIETOR)
- **Authorized official phone:** (505) 795-8190

## Contact information

- **Practice address:** 128 GRANT AVE, STE 218, SANTA FE, NM 87501-2031
- **Practice address phone:** (505) 795-8190
- **Mailing address:** 209 VUELTA ROBLE, SANTA FE, NM 87501-1625
- **Mailing address phone:** (505) 795-8190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 0103251 | NM | Yes |

## Other

- **Enumeration date:** 11/18/2009
- **Last updated:** 12/07/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 80473024 | — | NM |