Thomas B Collett

Individual provider Active NPI Peer Specialist · Celina, OH

NPI 1356971790 · NPPES record last updated Jan 24, 2020

Key facts

NPI
1356971790
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
4761 State Route 29
Celina, OH 45822-8216
Phone
(419) 584-1000
Fax
(419) 584-1825
NPI assigned
Jan 24, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Compdrug Past Accepting new patients
Compdrug Past Accepting new patients
Compdrug Past Accepting new patients
Compdrug Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

4761 State Route 29
Celina, OH 45822-8216

Mailing address

4761 State Route 29
Celina, OH 45822-8216
Phone (419) 584-1000

Other providers in Celina, OH

All providers in Celina, OH · Peer Specialist in Ohio

Sources for this page

Verify at the official NPI Registry.