# COLLABORATIVE CANCER CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Collaborative Cancer Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396516381
- **Authorized official:** WENDY GARVIN APRN (NURSE PRACTITIONER)
- **Authorized official phone:** (617) 650-3391

## Contact information

- **Practice address:** 112 SPENCER ST STE 2, MANCHESTER, CT 06040-4601
- **Practice address phone:** (860) 245-8853
- **Mailing address:** 8 BIRCHWOOD RD, EAST HARTFORD, CT 06118-1702
- **Mailing address phone:** (617) 650-3391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/10/2024
- **Last updated:** 05/22/2024