OrganizationActive
Collaborative Psych & Med
NPI 1972088912 · Geriatric Psychiatry Physician · Lakeland, FL
Provider details
- NPI number
- 1972088912
- Entity type
- Organization
- Primary specialty
- Geriatric Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kelly Wood, Administrator(855) 732-5292
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Adult Development & Aging Psychologist103TA0700X
Behavioral Health & Social Service Providers
- Case Manager/Care Coordinator171M00000X
Other Service Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4406 S Florida Ave Ste 31
Lakeland, FL 33813-2176
Phone: (855) 732-5292
Fax: (863) 583-9926
Street-level locationGet directions
Mailing address
4406 S Florida Ave Ste 31
Lakeland, FL 33813-2176
Registry dates
- Enumerated
- 2018-09-26
- Last updated
- 2018-09-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.