NPIMap

Organization Active NPI

Psych Collective

  • Social Worker
  • Coeur D Alene, ID
National Provider Identifier
1457112039
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
PSYCH COLLECTIVE
Practice address
1110 W Park PL Ste 202
Coeur D Alene, ID 83814-2783
Phone
(208) 244-0120
NPI assigned
Jan 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Chelsea Brouse, LMSWNPI 1689366890
Title
Co-Founder
Phone
(208) 244-0120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

1110 W Park PL Ste 202
Coeur D Alene, ID 83814-2783

Mailing address

1110 W Park PL Ste 202
Coeur D Alene, ID 83814-2783
Phone (208) 244-0120

Other names 1

  • The Cda Therapist Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1457112039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL STE 202",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142783",
            "telephone_number": "208-244-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL STE 202",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142783",
            "telephone_number": "208-244-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "BROUSE",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "208-244-0120",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Cda Therapist",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.