Provider Demographics
NPI:1568288959
Name:COLLINS, CHRISTY LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LYNN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41320 PENCADER WAY
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-8797
Mailing Address - Country:US
Mailing Address - Phone:443-465-5110
Mailing Address - Fax:
Practice Address - Street 1:44075 PIPELINE PLZ STE 225
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5889
Practice Address - Country:US
Practice Address - Phone:703-283-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040176801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical