Provider Demographics
NPI:1619111630
Name:COLLABORATIVE SOLUTIONS BY DR. NIKKI KEEFER & ASSOCIATES, INC
Entity Type:Organization
Organization Name:COLLABORATIVE SOLUTIONS BY DR. NIKKI KEEFER & ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:KEEFER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA
Authorized Official - Phone:407-489-2121
Mailing Address - Street 1:4541 ALRIX DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-3160
Mailing Address - Country:US
Mailing Address - Phone:407-489-2121
Mailing Address - Fax:407-352-2026
Practice Address - Street 1:4541 ALRIX DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-3160
Practice Address - Country:US
Practice Address - Phone:407-489-2121
Practice Address - Fax:407-352-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10896101Y00000X
101YM0800X, 101YP2500X, 103K00000X, 106H00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL685758296OtherMEDWAIVER DD
FL685758298OtherMEDWAIVER HCBS