NPIMap

Organization Active NPI

Collaborative Health Center, PLLC

  • Clinical Psychologist
  • Livonia, MI
National Provider Identifier
1609223825
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
COLLABORATIVE HEALTH CENTER, PLLC
Practice address
38807 Ann Arbor Rd Ste 9
Livonia, MI 48150
Phone
(734) 772-0148
Fax
(734) 943-6051
NPI assigned
May 17, 2016
Last updated
Aug 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Authorized official

Name
Peter Wyngaard
Title
Practice Manager
Phone
(734) 772-0148

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Psychologist 103T00000X NU
Clinical Psychologist 103TC0700X NU Primary
Social Worker 104100000X NU
Registered Dietitian 133V00000X NU

Addresses

Primary practice location

38807 Ann Arbor Rd Ste 9
Livonia, MI 48150

Mailing address

38807 Ann Arbor Rd
Suite 9
Livonia, MI 48150-3896
Phone (734) 772-0148

Other practice location 1

7091 Orchard Lake Rd Ste 240
West Bloomfield, MI 48322-3651
Phone (734) 772-0148

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160822000051 MI Part B Supplier - Clinic/Group Practice 3274828934 Receives reassigned benefits from 12 practitioners
Practice locations: Livonia, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1609223825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38807 ANN ARBOR RD",
            "address_2": "SUITE 9",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503896",
            "telephone_number": "734-772-0148",
            "fax_number": "734-943-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38807 ANN ARBOR RD STE 9",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48150",
            "telephone_number": "734-772-0148",
            "fax_number": "734-943-6051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7091 Orchard Lake Rd Ste 240",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223651",
            "country_code": "US",
            "telephone_number": "734-772-0148",
            "fax_number": "734-943-6051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLABORATIVE HEALTH CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "WYNGAARD",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "734-772-0148"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.