Provider Demographics
NPI:1508744053
Name:COLLINS, LEA M (LAPC)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:LEA
Other - Middle Name:M
Other - Last Name:SHIPWASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:365 MAUCH CHUNK ST
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-1921
Mailing Address - Country:US
Mailing Address - Phone:484-547-7285
Mailing Address - Fax:
Practice Address - Street 1:3735 NAZARETH RD STE 102
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8345
Practice Address - Country:US
Practice Address - Phone:610-443-0464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health