Provider Demographics
NPI:1316601339
Name:FAMILY COLLABORATIONS LLC
Entity Type:Organization
Organization Name:FAMILY COLLABORATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-974-7018
Mailing Address - Street 1:15 FORSYTHIA LN
Mailing Address - Street 2:
Mailing Address - City:OLIVETTE
Mailing Address - State:MO
Mailing Address - Zip Code:63132-2003
Mailing Address - Country:US
Mailing Address - Phone:314-974-7018
Mailing Address - Fax:314-392-9601
Practice Address - Street 1:2055 CRAIGSHIRE RD STE 120
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4012
Practice Address - Country:US
Practice Address - Phone:314-974-7018
Practice Address - Fax:314-392-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health