Provider Demographics
NPI:1316405202
Name:Q COLLECTIVE, LLC
Entity type:Organization
Organization Name:Q COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BECKER-WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:218-428-3495
Mailing Address - Street 1:1156 PIKE LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6404
Mailing Address - Country:US
Mailing Address - Phone:218-428-3495
Mailing Address - Fax:
Practice Address - Street 1:3413 WILSHIRE PL NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-1447
Practice Address - Country:US
Practice Address - Phone:218-428-3495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-09
Last Update Date:2019-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty