Provider Demographics
NPI:1437808185
Name:VILLAGE THERAPY COLLECTIVE, LLC
Entity Type:Organization
Organization Name:VILLAGE THERAPY COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:INDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMFT
Authorized Official - Phone:443-798-2450
Mailing Address - Street 1:400 REDLAND CT STE 101
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3291
Mailing Address - Country:US
Mailing Address - Phone:410-260-0585
Mailing Address - Fax:
Practice Address - Street 1:400 REDLAND CT STE 101
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3291
Practice Address - Country:US
Practice Address - Phone:410-260-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty