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General NPI Number Information
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NPI Number | 1316786023
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Entity Type | Organization
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Legal Business Name | THE COLLECTIVE CARE, LLC
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 1101 17TH AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-2257
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Country | US
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Telephone | 615-208-3397
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Fax |
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Provider Business Mailing Address
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Address Line | 7540 NOLENSVILLE RD
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City | NOLENSVILLE
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State | TN
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Zip | 37135-8406
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Country | US
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Telephone | 615-870-8220
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | COURTNEY GRIMES
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Credential | LCSW
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Telephone | 615-870-8220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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