Collective Self LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

COLLECTIVE SELF LLC

Practice address

4400 W Sample Rd Ste 112
Coconut Creek, FL 33073-3457

Phone

(954) 240-0884

Fax

(505) 438-1820

NPI assigned

Dec 4, 2023

Last updated

Dec 4, 2023By 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

Gwenevere AbrielNPI 1235668237

Title

Ceo

Phone

(954) 240-0884

Specialties & licenses 1

Addresses

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.

• Gwenevere E Abriel, LMFT

  • Marriage & Family Therapist
  • Coral Springs, FL
  • NPI 1235668237
  Authorized official Same address or phone

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1821864505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5379 LYONS RD # 172",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W SAMPLE RD STE 112",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733457",
            "telephone_number": "954-240-0884",
            "fax_number": "505-438-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE SELF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-03",
        "status": "A",
        "authorized_official_last_name": "ABRIEL",
        "authorized_official_first_name": "GWENEVERE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-240-0884"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coconut Creek Rehabilitation Inc (Coconut Creek Therapy)
• Coconut Creek Rehabilitation Inc (Coconut Creek Therapy)
• Cogent Healthcare of Jacksonville, LLC
• Elizabeth Ellen Cohen, PT
• Marc Samuel Cohen, M.S., M.D.
• Margaret Collier
• Casey A Collins, RBT
• Florin Coltea, PH.D.
• Columbus Therapy Group, LLC
• Comfort House Sober Living Plus, LLC.

• Marriage & Family Therapist in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.