Provider Demographics
NPI:1760701742
Name:COLLABORATIVE JOURNEYS, LLC
Entity Type:Organization
Organization Name:COLLABORATIVE JOURNEYS, LLC
Other - Org Name:COLLABORATIVE JOURNEYS, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:GWENDOLYN
Authorized Official - Last Name:DUCOTE-SABEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:720-560-1450
Mailing Address - Street 1:36533 COUNTY ROAD 153
Mailing Address - Street 2:
Mailing Address - City:AGATE
Mailing Address - State:CO
Mailing Address - Zip Code:80101-9614
Mailing Address - Country:US
Mailing Address - Phone:720-560-1450
Mailing Address - Fax:720-370-3381
Practice Address - Street 1:36533 COUNTY ROAD 153
Practice Address - Street 2:
Practice Address - City:AGATE
Practice Address - State:CO
Practice Address - Zip Code:80101-9614
Practice Address - Country:US
Practice Address - Phone:720-560-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-30
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2626103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
11975042OtherCAQH