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General NPI Number Information
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NPI Number | 1073499331
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE CHANGES COUNSELING, LLC
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 4648 SW 57TH CT
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City | GAINESVILLE
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State | FL
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Zip | 32608-0178
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Country | US
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Telephone | 352-246-7088
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Fax |
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Provider Business Mailing Address
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Address Line | 4648 SW 57TH CT
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City | GAINESVILLE
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State | FL
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Zip | 32608-0178
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Country | US
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Telephone | 352-246-7088
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON DUENAS
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Credential |
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Telephone | 352-246-7088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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