Individual provider Active NPI

Robert Darryl Collier-Freed

  • Marriage & Family Therapist
  • Dayton, OH
National Provider Identifier
1942440078
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
6030587-3902 Issued in UT
Practice address
7086 Corporate Way Ste 101
Dayton, OH 45459-4298
Phone
(801) 541-1212
NPI assigned
Mar 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 6030587-3902 UT Primary

Addresses

Primary practice location

7086 Corporate Way Ste 101
Dayton, OH 45459-4298

Mailing address

7086 Corporate Way Ste 101
Dayton, OH 45459-4298
Phone (801) 540-1212

Other names 1

  • Darryl Collier-Freed Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912002003 OH Practitioner - Marriage and Family Therapist 6305386616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7086 Corporate Way
Suite 101
Dayton, OH 45459-4298
Phone (801) 540-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6030587-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Collier-Freed Psychotherapy CurrentSince Jul 6, 2024 Accepting new patients
Shepherds Staff Christian Counseling Center Inc Past Accepting new patients

Locations

7086 Corporate Way
Ste 101
Dayton, OH 45459
Phone (801) 540-1212

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1942440078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7086 CORPORATE WAY STE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594298",
            "telephone_number": "801-540-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7086 CORPORATE WAY STE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594298",
            "telephone_number": "801-541-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER-FREED",
        "first_name": "ROBERT",
        "middle_name": "DARRYL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-02",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "6030587-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARRYL",
            "last_name": "COLLIER-FREED",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.