Provider Demographics
NPI:1275938086
Name:COLLABORATIVE CENTER, LLC
Entity Type:Organization
Organization Name:COLLABORATIVE CENTER, LLC
Other - Org Name:COLLABORATIVE COUNSELING CENTER OF DENVER
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-295-2282
Mailing Address - Street 1:2100 S CORONA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4516
Mailing Address - Country:US
Mailing Address - Phone:720-295-2282
Mailing Address - Fax:
Practice Address - Street 1:2100 S CORONA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4516
Practice Address - Country:US
Practice Address - Phone:720-295-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty