| Collaborative Endeavors, Llc | |
|
114 Housatonic St # 2 Lee MA 01238-1307 | |
| (413) 558-8002 | |
| Not Available |
| Full Name | Collaborative Endeavors, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 114 Housatonic St # 2, Lee, Massachusetts |
| Authorized Official Name and Position | Kimberly Girard (BILLER) |
| Authorized Official Contact | 4133205299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaborative Endeavors, Llc Unit 1010 740 Main St Ste 1 Great Barrington MA 01230 Ph: (413) 558-8002 | Collaborative Endeavors, Llc 114 Housatonic St # 2 Lee MA 01238-1307 Ph: (413) 558-8002 |
| NPI Number | 1609507680 |
|---|---|
| Provider Enumeration Date | 06/21/2022 |
| Last Update Date | 04/06/2023 |
| Certification Date | 04/03/2023 |
| Medicare PECOS PAC ID | 3274982798 |
|---|---|
| Medicare Enrollment ID | O20231209000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609507680 | NPI | - | NPPES |
| 0000P11223 | Other | MA | BCBS OF MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christina P Marks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982774261 PECOS PAC ID: 6204252943 Enrollment ID: I20200812002423 |
| Provider Name | Christine D Macros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336276849 PECOS PAC ID: 6608215454 Enrollment ID: I20240412003997 |
| Provider Name | Rania Markham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255091278 PECOS PAC ID: 7315203221 Enrollment ID: I20250214001803 |
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