Colliance Wellness PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

149016140 Issued in IL

Legal business name

COLLIANCE WELLNESS PLLC

Practice address

55 E Monroe St Ste 3800
Chicago, IL 60603-6030

Phone

(312) 714-0341

NPI assigned

Jan 5, 2018

Last updated

Jun 21, 2021By 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

Maria MirzaNPI 1518470368

Title

Psychotherapist/Owner

Phone

(312) 890-9266

Specialties & licenses 1

Addresses

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.

• Maria Mirza, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1518470368
  Authorized official Same address or phone

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1326555855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E MONROE ST STE 3800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E MONROE ST STE 3800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036030",
            "telephone_number": "312-714-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIANCE WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/OWNER",
        "authorized_official_telephone_number": "312-890-9266"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "149016140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Nicole Collett
• Collette Ara Honore MDSC
• Collette Counseling and Consulting, PLLC
• Giavanna Renee Colletti
• Morgan Colletti, MSN,FNP-C
• Evelyn Collier-Dixon, RN
• Casey Collier, MD
• Dawne Julia Collier, M.D.
• Donesha Collier
• Mary Collier, ATC

• Adult Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.