Provider Demographics
NPI:1942777305
Name:COLLABORATIVE COUNSELING TMS
Entity Type:Organization
Organization Name:COLLABORATIVE COUNSELING TMS
Other - Org Name:COLLABORATIVE COUNSELING TMS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-546-1100
Mailing Address - Street 1:5560 STERRETT PL STE 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2627
Mailing Address - Country:US
Mailing Address - Phone:443-546-1100
Mailing Address - Fax:443-546-4005
Practice Address - Street 1:5560 STERRETT PL STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2627
Practice Address - Country:US
Practice Address - Phone:443-546-1100
Practice Address - Fax:443-546-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1073591558OtherDR. BRETT GREENBERGER
MD1891946810OtherDR. CONSTANCE FLANAGAN