Provider Demographics
NPI:1437773611
Name:COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING PC
Entity Type:Organization
Organization Name:COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING PC
Other - Org Name:COLLABORATIVE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & LMHC
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MCEVOY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:929-306-6829
Mailing Address - Street 1:PO BOX 220062
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-0062
Mailing Address - Country:US
Mailing Address - Phone:929-306-6928
Mailing Address - Fax:929-419-9061
Practice Address - Street 1:302 5TH AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3604
Practice Address - Country:US
Practice Address - Phone:929-306-6829
Practice Address - Fax:929-419-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty