Provider Demographics
NPI:1841909645
Name:COLLINS, HARRY S (LICSW)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:S
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WESTGATE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3418
Mailing Address - Country:US
Mailing Address - Phone:518-727-0619
Mailing Address - Fax:
Practice Address - Street 1:7 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1520
Practice Address - Country:US
Practice Address - Phone:401-349-3131
Practice Address - Fax:401-921-5109
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228428101YM0800X
RIISW044071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA236Medicaid