Organization Active NPI

Collaborative Center for Individual & Marriage Therapy, Corp

  • Marriage & Family Therapist
  • Carlsbad, CA
National Provider Identifier
1427751619
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
COLLABORATIVE CENTER FOR INDIVIDUAL & MARRIAGE THERAPY, CORP
Practice address
2011 Palomar Airport Rd Ste 205
Carlsbad, CA 92011-1431
Phone
(760) 492-1098
NPI assigned
Mar 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Linda Stewart, LMFT
Title
Ceo
Phone
(760) 492-1098

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

2011 Palomar Airport Rd Ste 205
Carlsbad, CA 92011-1431

Mailing address

2647 Gateway Rd Ste 105-217
Carlsbad, CA 92009-1755
Phone (760) 492-1098

National Provider Directory

National Provider Directory

Locations

2647 Gateway Rd
Ste 105217
Carlsbad, CA 92009

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": "1679616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1427751619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 GATEWAY RD STE 105-217",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920091755",
            "telephone_number": "760-492-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 PALOMAR AIRPORT RD STE 205",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111431",
            "telephone_number": "760-492-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE CENTER FOR INDIVIDUAL & MARRIAGE THERAPY, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-492-1098",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.