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General NPI Number Information
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NPI Number | 1861034548
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Entity Type | Organization
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Legal Business Name | COLLECTIVE COUNSELING SOLUTIONS LLC
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 121 S MADISON ST STE C
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City | DENVER
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State | CO
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Zip | 80209-3019
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Country | US
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Telephone | 720-663-1465
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Fax |
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Provider Business Mailing Address
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Address Line | 3951 E DARTMOUTH AVE
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City | DENVER
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State | CO
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Zip | 80210-6619
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Country | US
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Telephone | 937-681-1547
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS MANCINI
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Credential | LPC, LMFT
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Telephone | 937-681-1547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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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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