THERAPEUTIC COLLABORATIVE (NPI# 1629123443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629123443 |
| Entity Type | Organization |
| Organization Name | THERAPEUTIC COLLABORATIVE |
| Practice Address |
519 Licking Pike Wilder KY 41071 |
| Practice Telephone | 8595720400 |
| Practice Fax Number | 8594423363 |
| Mailing Telephone | 8595720400 |
| Mailing Fax Number | 8594423363 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-06-17 |
| Authorized Official Name | MS. VIRGINIA ELLEN PEPPERS (PARTNER) |
| Authorized Official Telephone | 8595720400 |
| Authorized Official Credential | ARNP BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 364SP0807X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Adolescent |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65928897 | 05 |
| Street Address |
519 LICKING PIKE |
| City | WILDER |
| State | KY |
| Zip Code | 41071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558354167 | Anne Wier Eason | Social Worker | 519 Licking Pike, Therapeutic Collaborative, Wilder, KY 41071-2941 | 2005-08-30 |
| 1306374533 | Raymond Curtis Bartholomew IIi | Counselor | 519 Licking Pike, Wilder, KY 41071-2941 | 2017-06-01 |
| 1811257355 | Kathryn O Voorhees | Social Worker | 519 Licking Pike, Wilder, KY 41071-2941 | 2012-05-17 |
| 1639292246 | Jennifer Anne George Mcgraw | Art Therapist | 519 Licking Pike, Wilder, KY 41071-2941 | 2007-04-09 |
| 1437290822 | Kimberly Michelle Witte | Nurse Practitioner | 519 Licking Pike, Wilder, KY 41071 | 2007-02-09 |
| 1265579460 | Sally J Sweeney | Counselor | 519 Licking Pike, Suite 100, Wilder, KY 41071 | 2007-01-30 |
| 1144378225 | Kelly J Clasgens | Counselor | 519 Licking Pike, Wilder, KY 41071 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528598240 | Drew Austin Rappaport | Dentist | 70 Carothers Rd, Newport, KY 41071 | 2017-06-14 |
| 1811443435 | Marcus E. Mckinney | Pharmacist | 100 Aqua Way, Newport, KY 41071 | 2016-09-01 |
| 1730306754 | Benjamin Michael Anderson | Psychologist | 1400 Grand Avenue, Newport, KY 41071 | 2007-04-19 |
| 1437288065 | Douglas K Braun | Dentist | 40 E 9th St, Newport, KY 41071 | 2007-03-02 |
| 1952445017 | Therapeutic Collabortive | Social Worker | 525 Licking Pike, Wilder, KY 41071 | 2007-02-20 |
| 1215078407 | Holly Ann Eary | Counselor | 519 Licking Pk, Wilder, KY 41071 | 2007-02-09 |
| 1790839819 | James John Otrembiak | Pediatrics | 525 Alexandria Pike Ste 320, Southgate, KY 41071 | 2007-01-23 |
| 1326047903 | Stephen F Mielech | Podiatrist | 525 Alexandria Pike, Southgate, KY 41071 | 2005-07-18 |
| 1033737085 | Ashley Ryan | Nurse Practitioner | 215 E. 11th St., Newport, KY 41071 | 2020-07-07 |
| 1548733066 | Summt Medical Group, Inc | Clinic/Center | 1400 Grand Avenue, Newport, KY 41071 | 2019-01-08 |
| Find all providers in zip 41071 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255407466 | Specialized Alternatives for Families and Youth of Kentucky, Inc. | Clinic/Center | 1 Moock Rd Ste 101, Building B, Wilder, KY 41071-5465 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336614072 | Jason Muzzillo, Pllc | Clinic/Center | 168 E Reynolds Rd Ste 210, Lexington, KY 40517-1365 | 2018-10-09 |
| 1447660089 | Gateway Juvenile Diversion Project, Inc. | Clinic/Center | 37 North Maysville St, Mt Sterlig, KY 40353 | 2014-05-05 |
| 1073941837 | Specialized Alternatives for Families and Youth of Kentucky - Elizabet | Clinic/Center | 708 Westport Rd Ste 102, Elizabethtown, KY 42701-2866 | 2013-10-14 |
| 1538378203 | Rape Victim Services, Inc. | Clinic/Center | 1605 N Friendship Rd, Paducah, KY 42001-8650 | 2007-05-21 |
| 1104966357 | The Arc of Owensboro Inc. | Clinic/Center | 731 Jackson Street, Owensboro, KY 42303 | 2007-02-07 |
| 1346899275 | Mountain Comprehensive Care Center, Inc. | Clinic/Center | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2019-09-04 |
| 1336561265 | Couchimhc | Clinic/Center | 2415 Lime Kiln Ln, Suite B, Louisville, KY 40222-3429 | 2014-01-12 |
| 1083988919 | Specialized Alternatives for Families and Youth of Kentucky - Somerset | Clinic/Center | 3540 S Highway 27, Suite 4, Somerset, KY 42501-3026 | 2012-02-23 |
| 1720352651 | Specialized Alternatives for Families and Youth of Kentucky-louisville | Clinic/Center | 1169 Eastern Pkwy, Ste 3364, Louisville, KY 40217-1417 | 2012-02-23 |
| 1053692012 | Awareness and Discovery Group LLC | Clinic/Center | 2 Dortha Ave, Florence, KY 41042-2014 | 2011-09-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.