Collective Counseling Centre Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COLLECTIVE COUNSELING CENTRE INC

Practice address

24920 River Rd
N Dinwiddie, VA 23803-8332

Phone

(800) 940-5869

NPI assigned

May 15, 2023

Last updated

May 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donovan Burkhardt, M.ED

Title

Managing Member

Phone

(800) 940-5869

Specialties & licenses 1

Addresses

Other names 1

• Convenient Consulting INC Former legal business name

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1306536107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24920 RIVER RD",
            "city": "N DINWIDDIE",
            "state": "VA",
            "postal_code": "238038332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24920 RIVER RD",
            "city": "N DINWIDDIE",
            "state": "VA",
            "postal_code": "238038332",
            "telephone_number": "800-940-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE COUNSELING CENTRE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-14",
        "status": "A",
        "authorized_official_last_name": "BURKHARDT",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "800-940-5869",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convenient Consulting INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in N Dinwiddie, VA
• Providers in N Dinwiddie, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.