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General NPI Number Information
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NPI Number | 1790162519
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Entity Type | Organization
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Legal Business Name | COLLABORTATIVE COUNSELING SERVICERS, LLC
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 29 MARIAN RD
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-2930
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Country | US
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Telephone | 610-340-2626
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Fax | 610-340-2626
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Provider Business Mailing Address
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Address Line | 29 MARIAN RD
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-2930
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Country | US
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Telephone | 610-340-2626
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Fax | 610-340-2626
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Authorized Official
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Title or Position | CO-OWNER, THERAPIST
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Name | CHRISTOPHER JAMES CARBO
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Credential | MA, LPC, NCC, CAADC
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Telephone | 484-571-8919
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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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