Provider Demographics
NPI:1235937418
Name:THE COLLECTIVE ARTCONSCIOUS, PLLC
Entity type:Organization
Organization Name:THE COLLECTIVE ARTCONSCIOUS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MARROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, ATR-BC
Authorized Official - Phone:773-387-5853
Mailing Address - Street 1:23 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60040-1711
Mailing Address - Country:US
Mailing Address - Phone:773-387-5853
Mailing Address - Fax:
Practice Address - Street 1:540 W FRONTAGE RD STE 3520
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-1250
Practice Address - Country:US
Practice Address - Phone:773-387-5853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty