Healthcare Provider Details

I. General information

NPI: 1417349622
Provider Name (Legal Business Name): THE COLLABORATIVE FOR CHILDREN AND FAMILIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 AVENUE OF THE AMERICAS
NEW YORK NY
10011-2022
US

IV. Provider business mailing address

590 AVENUE OF THE AMERICAS
NEW YORK NY
10011-2022
US

V. Phone/Fax

Practice location:
  • Phone: 212-444-5437
  • Fax: 646-459-3989
Mailing address:
  • Phone: 212-444-5437
  • Fax: 646-459-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JODI A SAITOWITZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCSW-R
Phone: 322-228-1267