Collective Counseling Center, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

121289 Issued in MA

Legal business name

COLLECTIVE COUNSELING CENTER, LLC

Practice address

290 Turnpike Rd Ste 5-138
Westborough, MA 01581-2843

Phone

(508) 418-6608

Fax

(508) 475-9396

NPI assigned

Aug 21, 2018

Organization subpart

No

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

Authorized official

Name

Kelley A Smith, LICSWNPI 1093023517

Title

Owner

Phone

(508) 479-5202

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kelley Anne Smith, LICSW

  • Clinical Social Worker
  • Westborough, MA
  • NPI 1093023517
  NPD Authorized official

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1366923005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 TURNPIKE RD STE 5-138",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812843",
            "telephone_number": "508-479-5202",
            "fax_number": "508-475-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 TURNPIKE RD STE 5-138",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812843",
            "telephone_number": "508-418-6608",
            "fax_number": "508-475-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-479-5202",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MA",
            "license": "121289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093023517",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dyonera Beverly Amarah Clifton Belton
• David Cohen
• Melissa Cohlhepp, PHARMD
• Jennifer A Colebourn, MSPT
• Collaborative Parenting Services LLC
• Emily Collins, CGC
• Wanda Marie Colon-Cartagena, M.D.
• Commonwealth of Massachusetts-DMH
• Commonwealth of Massachusetts-DMH
• Community Neuroscience Services, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Westborough, MA
• Providers in Westborough, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.