Provider Demographics
NPI:1871391995
Name:MERKABA INTEGRATIVE PSYCHIATRY, LLC
Entity type:Organization
Organization Name:MERKABA INTEGRATIVE PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC, AGNP-BC, PAT-C
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, DNP
Authorized Official - Phone:651-366-0336
Mailing Address - Street 1:1023 LINWOOD AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3282
Mailing Address - Country:US
Mailing Address - Phone:651-366-0336
Mailing Address - Fax:657-877-6316
Practice Address - Street 1:1023 LINWOOD AVE APT 4
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3282
Practice Address - Country:US
Practice Address - Phone:651-321-3864
Practice Address - Fax:657-877-6316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health