Provider Demographics
NPI:1265771141
Name:COLLABORATIVE MENTAL HEALTH SERVICES INC
Entity type:Organization
Organization Name:COLLABORATIVE MENTAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:781-591-2775
Mailing Address - Street 1:246 WALNUT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1689
Mailing Address - Country:US
Mailing Address - Phone:617-244-3322
Mailing Address - Fax:617-581-6040
Practice Address - Street 1:264 UNION AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6348
Practice Address - Country:US
Practice Address - Phone:781-591-2775
Practice Address - Fax:774-244-4129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty