COLLECTIVE IMPACT SERVICES LLC
NPI 1083317010
Counselor - Professional in Petoskey, MI
About Collective Impact Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COLLECTIVE IMPACT SERVICES LLC (NPI 1083317010) is a healthcare organization registered as a professional in Petoskey, Michigan and active in the NPI registry since March 2023. The organization lists Julie Clark, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Collective Impact Services 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 Collective Impact Services 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 Collective Impact Services LLC's NPI number?
The NPI number for Collective Impact Services LLC is 1083317010. It was assigned to this organization in the NPPES registry on March 27, 2023.
Where is Collective Impact Services LLC located?
Collective Impact Services LLC is located at 616 Elizabeth St, Petoskey, MI 49770. The listed phone number is (231) 758-6776.
What is Collective Impact Services LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Collective Impact Services LLC enrolled in Medicare?
Yes. Collective Impact Services LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Collective Impact Services LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Collective Impact Services 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.
What insurance does Collective Impact Services LLC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Collective Impact Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Collective Impact Services LLC was last updated on April 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Collective Impact Services Llc · NPI 1083317010
Professional organization in Petoskey, Michigan. Organization record, active in the CMS NPPES registry since March 27, 2023.
## Identity
- **NPI:** 1083317010 (Entity type: Organization)
- **Enumerated:** March 27, 2023
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Organization subpart:** No
- **Authorized official:** Julie Clark, OWNER
## Practice location
- **Address:** 616 ELIZABETH ST, Petoskey, MI 49770
- **Phone:** (231) 758-6776
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Mental Health Counselor) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 17, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1083317010) · Data from the CMS NPPES public registry.