Organization Active NPI

Collaborative Care Network LLC

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1205723558
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
COLLABORATIVE CARE NETWORK LLC
Practice address
2 Richmond SQ Ste 204
Providence, RI 02906-5135
Phone
(401) 206-0130
NPI assigned
Jun 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Mrs. Fraynelis Y Andujar, LICSWNPI 1750072740
Title
Co-Founder / Clinician
Phone
(401) 749-4821

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

2 Richmond SQ Ste 204
Providence, RI 02906-5135

Mailing address

2 Richmond SQ Ste 204
Providence, RI 02906-5135
Phone (401) 206-0130

Other identifiers 3

IdentifierTypeStateIssuer
1548601347OtherMANPPES
1750072740OtherRINPPES
1184005456OtherMANPPES

National Provider Directory

National Provider Directory

Locations

2 Richmond Sq
Ste 204
Providence, RI 02906
Phone (401) 206-0130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1205723558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RICHMOND SQ STE 204",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065135",
            "telephone_number": "401-206-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RICHMOND SQ STE 204",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065135",
            "telephone_number": "401-206-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE CARE NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "ANDUJAR",
        "authorized_official_first_name": "FRAYNELIS",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CO-FOUNDER / CLINICIAN",
        "authorized_official_telephone_number": "401-749-4821",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1548601347",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1750072740",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1184005456",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.