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MOUNTAIN THERAPY COLLABORATIVE
NPI 1053825505
Psychologist - Group Psychotherapy in South Lake Tahoe, CA

Active since November 20, 2017
870 EMERALD BAY RD STE 303, SOUTH LAKE TAHOE, CA 96150(415) 806-0275(530) 600-0063 Get Directions Write a Review

NPPES record last updated: November 20, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mountain Therapy Collaborative NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN THERAPY COLLABORATIVE (NPI 1053825505) is a healthcare organization registered as a group psychotherapy in South Lake Tahoe, California and active in the NPI registry since November 2017. The organization lists Matthew Wong, Owner, as its authorized official.

NPPES Registry Identity

NPI1053825505
Entity TypeOrganization
Primary Taxonomy103TP2701X
Legal Business NameMOUNTAIN THERAPY COLLABORATIVE
Location Address870 EMERALD BAY RD STE 303South Lake Tahoe, CA 96150-9400
Mailing Address870 Emerald Bay Rd Ste 303South Lake Tahoe, CA 96150-9400 · (415) 806-0275 · Fax (530) 600-0063
Phone(415) 806-0275
Fax(530) 600-0063
Organization SubpartNo
Authorized OfficialMatthew WongOwner · (415) 806-0275
Enumeration DateNovember 20, 2017
✔ NPI 1053825505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · Group PsychotherapyBehavioral Health & Social Service Providers
Taxonomy Code103TP2701X
Definition
A psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings.
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedOccupational Therapy AssistantTaxonomy 224Z00000X
870 EMERALD BAY RD STE 303, South Lake Tahoe, CA 96150
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Other Identifiers 2

Medicaid1598157117CA
Medicaid1619169653NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Mountain Therapy Collaborative's NPI number?

The NPI number for Mountain Therapy Collaborative is 1053825505. It was assigned to this organization in the NPPES registry on November 20, 2017.

Where is Mountain Therapy Collaborative located?

Mountain Therapy Collaborative is located at 870 Emerald Bay Rd Ste 303, South Lake Tahoe, CA 96150. The listed phone number is (415) 806-0275.

What is Mountain Therapy Collaborative's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Group Psychotherapy, with taxonomy code 103TP2701X.

When was this NPI record last updated?

The NPPES record for Mountain Therapy Collaborative was last updated on November 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.