Provider Demographics
NPI:1437773611
Name:COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING PC
Entity type:Organization
Organization Name:COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & LMHC
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MCEVOY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:631-682-7741
Mailing Address - Street 1:136 MADISON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6796
Mailing Address - Country:US
Mailing Address - Phone:929-280-3994
Mailing Address - Fax:929-419-9061
Practice Address - Street 1:136 MADISON AVE FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6796
Practice Address - Country:US
Practice Address - Phone:929-280-3994
Practice Address - Fax:929-419-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty