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General NPI Number Information
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NPI Number | 1194624387
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Entity Type | Organization
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Legal Business Name | COLLECTIVE OF HEALING PLLC
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 707 REBA PL UNIT 1
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City | EVANSTON
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State | IL
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Zip | 60202-2616
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Country | US
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Telephone | 773-827-6701
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Fax |
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Provider Business Mailing Address
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Address Line | 707 REBA PL UNIT 1
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City | EVANSTON
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State | IL
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Zip | 60202-2616
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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 | OWNER AND CLINICIAN
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Name | HARDIK KOTAK
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Credential |
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Telephone | 773-827-6701
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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