Collaborative Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

835-123 Issued in WI

Legal business name

COLLABORATIVE PSYCHOTHERAPY, LLC

Practice address

6793 N Green Bay Ave
Glendale, WI 53209-3422

Phone

(414) 292-3900

Fax

(414) 292-3901

NPI assigned

May 7, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Terence Michael Gunville, LCSW

Title

Psychotherapist

Phone

(414) 292-3900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1669731972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8961 W PALMETTO CT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532255017",
            "telephone_number": "414-536-8604",
            "fax_number": "414-536-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6793 N GREEN BAY AVE",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093422",
            "telephone_number": "414-292-3900",
            "fax_number": "414-292-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-07",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "GUNVILLE",
        "authorized_official_first_name": "TERENCE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "414-292-3900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "835-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Cloutier, PT, DPT
• Elizabeth Laura Cloyd, MS CCC SLP
• Mitchell R Cohen, SAC-IT, PCTL
• Susan E Cohen, LCSW
• Maelynn D Colinco, MD
• Columbia St. Mary'S Hospital Milwaukee, Inc
• Columbia St. Mary'S Hospital Milwaukee, Inc
• Columbia St. Mary'S Hospital Milwaukee, Inc.
• Compassion Psychotherapy Center LLC
• Compassionate Hearts Home Care LLC

• Clinical Social Worker in Glendale, WI
• Providers in Glendale, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.