Provider Demographics
NPI:1225804883
Name:COLLECTIVE FOR PSYCHOLOGICAL WELLNESS
Entity Type:Organization
Organization Name:COLLECTIVE FOR PSYCHOLOGICAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-596-1735
Mailing Address - Street 1:2500 30TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1238
Mailing Address - Country:US
Mailing Address - Phone:303-596-1735
Mailing Address - Fax:
Practice Address - Street 1:2500 30TH ST STE 201
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1238
Practice Address - Country:US
Practice Address - Phone:303-596-1735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)