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General NPI Number Information
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NPI Number | 1144029257
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Entity Type | Organization
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Legal Business Name | COLLECTIVE MINDS, LLC
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 08/24/2025
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Provider Practice Location Address
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Address Line | 1411 W COUNTY LINE RD STE A
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City | GREENWOOD
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State | IN
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Zip | 46142-5250
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Country | US
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Telephone | 978-514-4999
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Fax |
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Provider Business Mailing Address
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Address Line | 1411 W COUNTY LINE RD STE A
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City | GREENWOOD
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State | IN
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Zip | 46142-5250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | JOANNE TARANTINO
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Credential | LICSW
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Telephone | 978-514-4999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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