Healthcare Provider Details

I. General information

NPI: 1417764622
Provider Name (Legal Business Name): COLLABORATIVE CARE COUNSELING AND EDUCATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 01/18/2025
Certification Date: 01/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 DELLFIELD WAY
COLUMBUS OH
43230-3223
US

IV. Provider business mailing address

311 DELLFIELD WAY
COLUMBUS OH
43230-3223
US

V. Phone/Fax

Practice location:
  • Phone: 614-440-2621
  • Fax:
Mailing address:
  • Phone: 614-440-2621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALMA LOVINS
Title or Position: OWNER
Credential:
Phone: 614-440-2621