Collegiate Behavioral Health Associates

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

COLLEGIATE BEHAVIORAL HEALTH ASSOCIATES

Practice address

6809 Sawgrass Dr
Fort Worth, TX 76132-7103

Phone

(833) 244-5700

NPI assigned

Feb 6, 2023

Organization subpart

No

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

Authorized official

Name

Sharon Black

Title

Billing MGR

Phone

(214) 579-9151

Specialties & licenses 1

Addresses

Other names 1

• Collegiate Behavioral Health Associates Former legal business name

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1720784259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 W PALMETTO PARK RD STE 308",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 SAWGRASS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761327103",
            "telephone_number": "833-244-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGIATE BEHAVIORAL HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "214-579-9151"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collegiate Behavioral Health Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• William G Coleman, MD
• Samuel Coleridge
• Colinasverse Iom LLC
• Taylor Collazo
• Collective Services, Inc
• Lori L. Colletti, M.S.,CCC-SLP
• Colleyverse Iom, LLC
• Cristy Collier-Moya, LVN
• Catherine Collier, LCSW
• Harley Collier, PA-C

• Adult Mental Health Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Adult Mental Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.