Provider Demographics
NPI:1841835212
Name:COLLINS, LAUREN ELISABETH (PMHNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISABETH
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 CILANTRO CT
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708-0133
Mailing Address - Country:US
Mailing Address - Phone:804-616-8471
Mailing Address - Fax:
Practice Address - Street 1:1404 CILANTRO CT
Practice Address - Street 2:
Practice Address - City:TEGA CAY
Practice Address - State:SC
Practice Address - Zip Code:29708-0133
Practice Address - Country:US
Practice Address - Phone:804-616-8471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC000000002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry