MEDICARE: COLLECTIVE GROWTH COUNSELING & SUPERVISION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1083547970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLECTIVE GROWTH COUNSELING & SUPERVISION LLC

Provider Business Mailing Address
First Line	:	597 MILLVILLE AVE APT 6-9
Second Line	:
City	:	NAUGATUCK
State	:	CT
Zip	:	06770-2334
Country	:	US
Telephone Number	:	203-841-7711
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 MAIN ST STE 8
Second Line	:
City	:	MONROE
State	:	CT
Zip	:	06468-2830
Country	:	US
Telephone Number	:	203-841-7711
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH COUNSELOR
Name	:	MRS. JULIA BARROWS NORD
Credential	:	LPC
Telephone Number	:	203-841-7711

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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