Provider Demographics
NPI:1003524422
Name:COLLABORATIVE CONNECTIONS COUNSELING SOLUTIONS LLC
Entity Type:Organization
Organization Name:COLLABORATIVE CONNECTIONS COUNSELING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARONA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-479-9950
Mailing Address - Street 1:4801 S UNIVERSITY DR STE 219
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3837
Mailing Address - Country:US
Mailing Address - Phone:954-393-5846
Mailing Address - Fax:
Practice Address - Street 1:4801 S UNIVERSITY DR STE 219
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3837
Practice Address - Country:US
Practice Address - Phone:954-479-9950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty