| Collaborative Minds Therapy Llc | |
|
217 Se 1st Ave Ste 200 Ocala FL 34471-2161 | |
| (352) 403-0875 | |
| (352) 309-6006 |
| Full Name | Collaborative Minds Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 217 Se 1st Ave Ste 200, Ocala, Florida |
| Authorized Official Name and Position | April Russell (SOLE OWNER) |
| Authorized Official Contact | 3524030875 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaborative Minds Therapy Llc 217 Se 1st Ave Ste 200 Ocala FL 34471-2161 Ph: (352) 403-0875 | Collaborative Minds Therapy Llc 217 Se 1st Ave Ste 200 Ocala FL 34471-2161 Ph: (352) 403-0875 |
| NPI Number | 1912785445 |
|---|---|
| Provider Enumeration Date | 09/18/2023 |
| Last Update Date | 09/18/2023 |
| Certification Date | 09/16/2023 |
| Medicare PECOS PAC ID | 7618323734 |
|---|---|
| Medicare Enrollment ID | O20231026000855 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912785445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | April Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720762313 PECOS PAC ID: 8527414648 Enrollment ID: I20231026001059 |
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