FREEDOM COLLECTIVE THERAPY GROUP NPI 1912687708

NPI Information

NPI: 1912687708
Provider Name: FREEDOM COLLECTIVE THERAPY GROUP

Doing Business As: COLLECTIVE THERAPY GROUP

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
22792 CENTRE DR STE 104
LAKE FOREST, CA
ZIP 92630
Phone: (714) 326-3722
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FREEDOM COLLECTIVE THERAPY GROUP is a mental health counselor in Lake Forest, CA. FREEDOM COLLECTIVE THERAPY GROUP NPI is 1912687708. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Collective Therapy Group.

The provider's business location address is:

22792 CENTRE DR STE 104
LAKE FOREST, CA
ZIP 92630-311
Phone: (714) 326-3722

The provider's authorized official is Chandra Medina .
The authorized official title is Owner and has the following contact phone number (714) 326-3722.

The enumeration date for this NPI number is 7/18/2023 and was last updated on 7/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	106H00000X	Marriage & Family Therapist				No
2	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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