MEDICARE: THE THERAPY COLLECTIVE, PLLC

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	1041C0700X	Clinical Social Worker
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1780281139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE THERAPY COLLECTIVE, PLLC

Provider Business Mailing Address
First Line	:	1325 S COLORADO BLVD STE 410
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3341
Country	:	US
Telephone Number	:	205-399-1428
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 S COLORADO BLVD STE 410
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3341
Country	:	US
Telephone Number	:	720-282-9750
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANGELICA ABSTON
Credential	:	LPC
Telephone Number	:	205-399-1428

Provider Enumeration Date	:	10/07/2020
Last Update Date	:	11/29/2022

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