NPIMap

Organization Active NPI

Collaborative Wellness Solutions LLC

  • Clinical Social Worker
  • Charlestown, MA
National Provider Identifier
1124793195
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COLLABORATIVE WELLNESS SOLUTIONS LLC
Practice address
30 High St Apt 1
Charlestown, MA 02129-3338
Phone
(978) 505-9800
NPI assigned
Aug 12, 2021
Last updated
Aug 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Mrs. Alexa Roe, LICSWNPI 1235775982
Title
Founder
Phone
(978) 505-9800

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
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

30 High St Apt 1
Charlestown, MA 02129-3338

Mailing address

30 High St Apt 1
Charlestown, MA 02129-3338
Phone (978) 505-9800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alexa@collaborativewellness.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1124793195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HIGH ST APT 1",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293338",
            "telephone_number": "978-505-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HIGH ST APT 1",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293338",
            "telephone_number": "978-505-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE WELLNESS SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "ROE",
        "authorized_official_first_name": "ALEXA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "978-505-9800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alexa@collaborativewellness.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "30 High St Apt 1",
            "city": "Charlestown",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021293338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlestown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.