Provider Demographics
NPI:1851862932
Name:COLLABORATIVE THERAPY & COACHING PLLC
Entity Type:Organization
Organization Name:COLLABORATIVE THERAPY & COACHING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-440-8822
Mailing Address - Street 1:25 MAIN ST STE 218
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3130
Mailing Address - Country:US
Mailing Address - Phone:505-440-8822
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST STE 218
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3130
Practice Address - Country:US
Practice Address - Phone:505-440-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health