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General NPI Number Information
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NPI Number | 1942895404
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Entity Type | Organization
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Legal Business Name | COLLECTIVE PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 03/06/2021
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 1235 NORTH LOOP W STE 918
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City | HOUSTON
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State | TX
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Zip | 77008-4707
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Country | US
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Telephone | 713-482-1266
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Fax |
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Provider Business Mailing Address
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Address Line | 15035 RAFFIA LEAVE WAY
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City | HOUSTON
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State | TX
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Zip | 77090-5016
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Country | US
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Telephone | 334-730-8010
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHUNDRIKA JONES
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Credential | LPC
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Telephone | 334-730-8010
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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 | 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 #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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Taxonomy #4
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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 #5
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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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