Individual provider Active NPI

Leslie Joubert Collazo

  • Counselor
  • Cape Coral, FL
National Provider Identifier
1982008777
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MH26304 Issued in FL
Practice address
1361 Weeping Willow CT
Cape Coral, FL 33909-8702
Phone
(413) 693-3704
NPI assigned
Oct 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MH26304 FL Primary

Addresses

Primary practice location

1361 Weeping Willow CT
Cape Coral, FL 33909-8702

Mailing address

1361 Weeping Willow CT
Cape Coral, FL 33909-8702
Phone (413) 693-3704

Other identifiers 3

IdentifierTypeStateIssuer
M18463OtherMABLUE CROSS BLUE SHIELD
1303295MedicaidMA
1307576MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260303003098 FL Practitioner - Mental Health Counselor 8224510979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Therapy Treatment Team LLCGroup PAC ID 0446594451, 22 clinicians

Practice addresses (Care Compare)

12811 Kenwood LN
Suite 202
Fort Myers, FL 33907-5646
Phone (239) 537-9646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH26304FLMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Treatment Team LLC CurrentSince Feb 25, 2026 Accepting new patients

Locations

12811 Kenwood Ln
Ste 202
Fort Myers, FL 33907
Phone (239) 537-9646

Organizations & group practices 1

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": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1982008777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 WEEPING WILLOW CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339098702",
            "telephone_number": "413-693-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 WEEPING WILLOW CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339098702",
            "telephone_number": "413-693-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUBERT COLLAZO",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH26304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M18463",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303295",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1307576",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.