Healthcare Provider Details

I. General information

NPI: 1235808635
Provider Name (Legal Business Name): THE CARE COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7711 BONHOMME AVE STE 850
CLAYTON MO
63105-1964
US

IV. Provider business mailing address

7711 BONHOMME AVE STE 850
CLAYTON MO
63105-1964
US

V. Phone/Fax

Practice location:
  • Phone: 617-640-6883
  • Fax:
Mailing address:
  • Phone: 617-640-6883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: DENA B TRANEN
Title or Position: FOUNDER/OWNER
Credential: LCSW
Phone: 617-640-6883