NPIMap

Organization Active NPI

Mental Health Collective, LLC

Doing business as Mental Health Collective

  • Mental Health Counselor
  • Fitchburg, WI
National Provider Identifier
1073169975
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MENTAL HEALTH COLLECTIVE, LLC
Doing business as
Mental Health Collective
Practice address
2961 Yarmouth Greenway Dr Ste B
Fitchburg, WI 53711-5809
Phone
(608) 445-6064
Fax
(608) 416-1535
NPI assigned
Aug 15, 2019
Last updated
Aug 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica Abegglen, LPCNPI 1124431390
Title
Owner
Phone
(608) 445-6064

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2961 Yarmouth Greenway Dr Ste B
Fitchburg, WI 53711-5809

Mailing address

2961 Yarmouth Greenway Dr Ste B
Fitchburg, WI 53711-5809
Phone (608) 445-6064

Other names 1

  • Mental Health Collective Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@mentalhealthcollectivellc.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1073169975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 YARMOUTH GREENWAY DR STE B",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115809",
            "telephone_number": "608-445-6064",
            "fax_number": "608-416-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 YARMOUTH GREENWAY DR STE B",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115809",
            "telephone_number": "608-445-6064",
            "fax_number": "608-416-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH COLLECTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "ABEGGLEN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-445-6064",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mentalhealthcollectivellc.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2961 Yarmouth Greenway Dr Ste B",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537115809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mental Health Collective",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.