Provider Demographics
NPI:1154988509
Name:COLLINS, CHRISTINA (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W SAINT JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MI
Mailing Address - Zip Code:49064-9315
Mailing Address - Country:US
Mailing Address - Phone:231-357-0389
Mailing Address - Fax:
Practice Address - Street 1:229 E MICHIGAN AVE STE 345
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-6403
Practice Address - Country:US
Practice Address - Phone:269-254-6613
Practice Address - Fax:269-443-2166
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016673101YP2500X
MI6401019166101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional