Provider Demographics
NPI:1487126280
Name:COLLINS, SHEILA MARIE (LMSW, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LMSW, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1140
Mailing Address - Country:US
Mailing Address - Phone:716-375-4747
Mailing Address - Fax:
Practice Address - Street 1:1439 BUFFALO ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1140
Practice Address - Country:US
Practice Address - Phone:716-375-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000747-1103K00000X
NY103911-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst