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General NPI Number Information
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NPI Number | 1063225548
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Entity Type | Organization
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Legal Business Name | COGNITIVE BEHAVIORAL COLLECTIVE, A PROFESSIONAL LICENSED CLINICAL SOCIAL WORKER CORPORATION
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 307 ORCHARD CITY DR STE 310
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City | CAMPBELL
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State | CA
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Zip | 95008-2948
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Country | US
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Telephone | 408-758-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 307 ORCHARD CITY DR STE 310
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City | CAMPBELL
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State | CA
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Zip | 95008-2948
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Country | US
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Telephone | 408-758-0347
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EMILY PEREZ
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Credential | LMFT
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Telephone | 707-334-0477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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