Collaborative Counseling Center

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

45342 Issued in CA

Legal business name

COLLABORATIVE COUNSELING CENTER

Practice address

6001 Butler LN Ste 206
Scotts Valley, CA 95066-3550

Phone

(831) 588-8032

Fax

(831) 440-9016

NPI assigned

Nov 28, 2012

Last updated

Nov 28, 2012By 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

Mrs. Cassia Lea Bloom, MFTNPI 1902974462

Title

Marriage Family Therapist/ Owner

Phone

(831) 588-8032

Specialties & licenses 2

Addresses

Locations

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.

• Cassia Lea Bloom, LMFT

  • Marriage & Family Therapist
  • Scotts Valley, CA
  • NPI 1902974462
  NPD (past) Authorized official

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1528303823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 BUTLER LN STE 206",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950663550",
            "telephone_number": "831-588-8032",
            "fax_number": "831-440-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 BUTLER LN STE 206",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950663550",
            "telephone_number": "831-588-8032",
            "fax_number": "831-440-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "CASSIA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "MARRIAGE FAMILY THERAPIST/ OWNER",
        "authorized_official_telephone_number": "831-588-8032",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28615",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "45342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Scotts Valley, CA
• Providers in Scotts Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.