Provider Demographics
NPI:1215175179
Name:COLLINS PSYCHOLOGICAL THERAPY & CONSULTING INC.
Entity type:Organization
Organization Name:COLLINS PSYCHOLOGICAL THERAPY & CONSULTING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-296-7757
Mailing Address - Street 1:3707 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4111
Mailing Address - Country:US
Mailing Address - Phone:619-296-7757
Mailing Address - Fax:
Practice Address - Street 1:3707 3RD AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4111
Practice Address - Country:US
Practice Address - Phone:619-296-7757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16251103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty