Provider Demographics
NPI:1407683527
Name:THERAPEUTIC COLLABORATIVE, LLC
Entity type:Organization
Organization Name:THERAPEUTIC COLLABORATIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:806-786-2015
Mailing Address - Street 1:6959 WHITE WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-4307
Mailing Address - Country:US
Mailing Address - Phone:806-786-2015
Mailing Address - Fax:
Practice Address - Street 1:6959 WHITE WILLOW CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-4307
Practice Address - Country:US
Practice Address - Phone:806-786-2015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-14
Last Update Date:2025-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty