Organization Active NPI

Collier-Freed Psychotherapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
National Provider Identifier
1457971210
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COLLIER-FREED PSYCHOTHERAPY
Practice address
7086 Corporate Way Ste 101
Dayton, OH 45459-4298
Phone
(801) 540-1212
NPI assigned
Apr 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Mr. Robert Darryl Collier-Freed, IMFTNPI 1942440078
Title
Marriage and Family Therapist
Phone
(801) 540-1212

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

7086 Corporate Way Ste 101
Dayton, OH 45459-4298

Mailing address

9072 Academy View CT
Dayton, OH 45458-9657
Phone (801) 540-1212

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL collierfreed@hush.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240912001737 OH Part B Supplier - Clinic/Group Practice 5890235105 Receives reassigned benefits from 1 practitioner
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

7086 Corporate Way
Ste 101
Dayton, OH 45459
Phone (801) 540-1212

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": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1457971210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9072 ACADEMY VIEW CT",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454589657",
            "telephone_number": "801-540-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7086 CORPORATE WAY STE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594298",
            "telephone_number": "801-540-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER-FREED PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "COLLIER-FREED",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DARRYL",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "801-540-1212",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "IMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "collierfreed@hush.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "7086 Corporate Way Ste 101",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454594298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.