COLLABORATIVE ADULT PSYCHIATRY LLC.
NPI 1003614645
Nurse Practitioner - Psychiatric/Mental Health in Jacksonville, FL
About Collaborative Adult Psychiatry Llc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COLLABORATIVE ADULT PSYCHIATRY LLC. (NPI 1003614645) is a healthcare organization registered as a psychiatric/mental health in Jacksonville, Florida and active in the NPI registry since March 2025. The organization lists Andrea M House, Owner And Primary Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Collaborative Adult Psychiatry Llc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Collaborative Adult Psychiatry LLC., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Collaborative Adult Psychiatry LLC.'s NPI number?
The NPI number for Collaborative Adult Psychiatry LLC. is 1003614645. It was assigned to this organization in the NPPES registry on March 7, 2025.
Where is Collaborative Adult Psychiatry LLC. located?
Collaborative Adult Psychiatry LLC. is located at 12412 San Jose Blvd Ste 304D, Jacksonville, FL 32223. The listed phone number is (904) 706-1551.
What is Collaborative Adult Psychiatry LLC.'s specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Collaborative Adult Psychiatry LLC. enrolled in Medicare?
Yes. Collaborative Adult Psychiatry LLC. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Collaborative Adult Psychiatry LLC.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Collaborative Adult Psychiatry LLC.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Collaborative Adult Psychiatry LLC. was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Collaborative Adult Psychiatry Llc. · NPI 1003614645
Psychiatric/Mental Health organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since March 7, 2025.
## Identity
- **NPI:** 1003614645 (Entity type: Organization)
- **Enumerated:** March 7, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Andrea House, OWNER AND PRIMARY PROVIDER
## Practice location
- **Address:** 12412 SAN JOSE BLVD STE 304D, Jacksonville, FL 32223-8620
- **Phone:** (904) 706-1551
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1003614645) · Data from the CMS NPPES public registry.