Collage Therapeutic Group LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

COLLAGE THERAPEUTIC GROUP LLC

Practice address

6325 Guilford Ave Ste 206
Indianapolis, IN 46220-1741

Phone

(317) 722-0999

NPI assigned

Oct 30, 2018

Organization subpart

No

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

Authorized official

Name

Benjamin Meadows, LCSWNPI 1356638241

Title

Owner

Phone

(317) 722-0999

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Thomas Meadows, MSW, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1356638241
  NPD (past) Authorized official

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1639646409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 GUILFORD AVE STE 206",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201741",
            "telephone_number": "317-722-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 GUILFORD AVE STE 206",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201741",
            "telephone_number": "317-722-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLAGE THERAPEUTIC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "MEADOWS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-722-0999",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Theresa Colgan, RN
• Jenell Colgan
• Shelby Nicole Colglazier
• Doug Colgrove, MS, LSW
• Collaborative Care Home Health Agency LLC
• Idamarie Collazo, LSW
• Colleen Caito Counseling, LLC
• College Park Oral & Maxillofacial Surgery
• Lindsey Collett, MSW, LCSW
• Lucas Collett, RBT

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.