Collective Centre of Psychology, Inc.

Primary specialty

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

Legal business name

COLLECTIVE CENTRE OF PSYCHOLOGY, INC.

Practice address

27201 Puerta Real Ste 300
Mission Viejo, CA 92691-8590

Phone

(949) 354-4147

NPI assigned

Dec 12, 2017

Last updated

Dec 12, 2017By 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

Deke Marcus, PSYDNPI 1346787389

Title

President

Phone

(949) 354-4147

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Deke Marcus, PSYD

  • Clinical Psychologist
  • Irvine, CA
  • NPI 1346787389
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1437664539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23986 ALISO CREEK RD STE 325",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27201 PUERTA REAL STE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918590",
            "telephone_number": "949-354-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE CENTRE OF PSYCHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "DEKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-354-4147",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S Cohen, M.P.T.
• Sydney Alyssa Cohen
• Kristie Cole, R.N.
• John Raymond Coleman, AU.D.
• Rachel Coleman, M.A., MFT
• Shakayla Collins
• Arlene Cory Colon, M.A, CCC-SLP
• Community Orthopedic Medical Group
• Complete Care Family Medicine
• Complete Care Family Medicine and Skin Center

• Mental Health Clinic/Center (Including Community Mental Health Center) in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.