Mountain Therapy Collaborative
LBN: Mountain Therapy Collaborative
Mountain Therapy Collaborative is an health care organization with primary practice located at 870 Emerald Bay Rd Ste 303 , South Lake Tahoe CA 96150-9400. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Clinical, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant. Behavioral Health & Social Service Providers / Group Psychotherapy is the primary health care specialty.
Mountain Therapy Collaborative can be contacted via phone (415) 806-0275, or through Wong, Matthew via phone (415) 806-0275.
Contact Information
Primary practice address
870 Emerald Bay Rd Ste 303
South Lake Tahoe CA 96150-9400
Phone: (415) 806-0275
Fax: (530) 600-0063
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | ||
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant | 224Z00000X |
Profile Details
NPI number | 1053825505 |
---|---|
LBN Legal business name | Mountain Therapy Collaborative |
DBA Doing business as | |
Authorized official | Wong, Matthew M.A., PSY.D. |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Nov 20th, 2017 |
Last updated | Nov 20th, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053825505 | NPPES |
California | MEDICAID | 1598157117 | |
California | MEDICAID | 1619169653 |
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