Provider Demographics
NPI:1790381184
Name:MARISSA BATIE-COLLIER DIVINE HEALTHCARE CONSULTING
Entity Type:Organization
Organization Name:MARISSA BATIE-COLLIER DIVINE HEALTHCARE CONSULTING
Other - Org Name:SG MENTAL HEALTH COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATIE-COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:850-688-4426
Mailing Address - Street 1:3821 CASTLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2113
Mailing Address - Country:US
Mailing Address - Phone:850-688-4426
Mailing Address - Fax:
Practice Address - Street 1:2940 E PARK AVE UNIT 2-J
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3446
Practice Address - Country:US
Practice Address - Phone:850-405-3639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty