INTEGRATED LIFE THERAPEUTIC SOLUTIONS
NPI 1396423240
Social Worker - Clinical in Baltimore, MD

Active since July 10, 2023
4024 COLBORNE RD, BALTIMORE, MD 21229(443) 422-5095 Get Directions Write a Review

NPPES record last updated: July 10, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Integrated Life Therapeutic Solutions NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTEGRATED LIFE THERAPEUTIC SOLUTIONS (NPI 1396423240) is a healthcare organization registered as a clinical in Baltimore, Maryland and active in the NPI registry since July 2023. The organization lists Khadejah Mcdougald, Owner, as its authorized official.

NPPES Registry Identity

NPI1396423240
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameINTEGRATED LIFE THERAPEUTIC SOLUTIONS
Location Address4024 COLBORNE RDBaltimore, MD 21229-1903
Mailing Address4024 Colborne RdBaltimore, MD 21229-1903 · (443) 422-5095
Organization SubpartNo
Authorized OfficialKhadejah McdougaldOwner · (443) 422-5095
Enumeration DateJuly 10, 2023
NPPES CertifiedJuly 10, 2023
✔ NPI 1396423240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4024 COLBORNE RD, Baltimore, MD 21229

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Integrated Life Therapeutic Solutions is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Integrated Life Therapeutic Solutions, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Clinical Social Worker
NPI 1689345993
4200 EDMONDSON AVE STE 202A
Baltimore, MD 21229
(667) 205-1646
✔ PECOS✔ Accepts Medicare0.3 mi
Mental Health Counselor
NPI 1053639138
108 N POTOMAC ST SUITE 3A
Hagerstown, MD 21740
(240) 344-8724
✔ PECOS✔ Accepts Medicare60 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Integrated Life Therapeutic Solutions's NPI number?

The NPI number for Integrated Life Therapeutic Solutions is 1396423240. It was assigned to this organization in the NPPES registry on July 10, 2023.

Where is Integrated Life Therapeutic Solutions located?

Integrated Life Therapeutic Solutions is located at 4024 Colborne Rd, Baltimore, MD 21229. The listed phone number is (443) 422-5095.

What is Integrated Life Therapeutic Solutions's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Integrated Life Therapeutic Solutions enrolled in Medicare?

Yes. Integrated Life Therapeutic Solutions is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrated Life Therapeutic Solutions?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Integrated Life Therapeutic Solutions, in Clinical Social Worker and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Integrated Life Therapeutic Solutions was last updated on July 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.