Provider Demographics
NPI:1619352226
Name:COLLABORATIVE SOLUTIONS IN PSYCHIATRY, SC
Entity Type:Organization
Organization Name:COLLABORATIVE SOLUTIONS IN PSYCHIATRY, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOBIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRMANI-MOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-713-9898
Mailing Address - Street 1:6515 GRAND TETON PLZ STE 220
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1048
Mailing Address - Country:US
Mailing Address - Phone:608-713-9898
Mailing Address - Fax:608-713-9647
Practice Address - Street 1:6515 GRAND TETON PLZ STE 220
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1048
Practice Address - Country:US
Practice Address - Phone:608-713-9898
Practice Address - Fax:608-713-9647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57589-20251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health