Collaborative Psych & Med

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

Legal business name

COLLABORATIVE PSYCH & MED

Practice address

4406 S Florida Ave Ste 31
Lakeland, FL 33813-2176

Phone

(855) 732-5292

Fax

(863) 583-9926

NPI assigned

Sep 26, 2018

Organization subpart

No

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

Authorized official

Name

Kelly Wood, BSW

Title

Administrator

Phone

(855) 732-5292

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1972088912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 S FLORIDA AVE STE 31",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132176",
            "telephone_number": "855-732-5292",
            "fax_number": "863-583-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406 S FLORIDA AVE STE 31",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132176",
            "telephone_number": "855-732-5292",
            "fax_number": "863-583-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE PSYCH & MED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "855-732-5292",
        "authorized_official_credential": "BSW"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Hunter Cole, APRN
• Emily Cole, SLP
• Grant Preston Cole
• Kim G Cole, PA
• Terrin L Colee, CRNA
• Teresa M Colletti, ARNP
• Sandra Lee Collier, APRN
• Colliers at Lakeland Opco, LLC
• Kiani Collins-Pierre, BEHAVIOR TECHNICIAN
• Cameron Dane Collins, DMD

• Geriatric Psychiatry Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Geriatric Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.