Healthcare Provider Details

I. General information

NPI: 1568266385
Provider Name (Legal Business Name): COLLECTIVE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4430 N HOLLAND SYLVANIA RD BLDG 4 APT 4430
TOLEDO OH
43623-3558
US

IV. Provider business mailing address

4430 N HOLLAND SYLVANIA RD BLDG 4 APT 4430
TOLEDO OH
43623-3558
US

V. Phone/Fax

Practice location:
  • Phone: 419-740-0491
  • Fax:
Mailing address:
  • Phone: 419-740-0491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MELISSA A WELCH
Title or Position: LISW-S
Credential:
Phone: 419-740-0491