Provider Demographics
NPI:1932530607
Name:COLLINS, KAITLIN MARIE (LPC)
Entity type:Individual
Prefix:MISS
First Name:KAITLIN
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 HILLCREST BLVD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4382
Mailing Address - Country:US
Mailing Address - Phone:734-808-2925
Mailing Address - Fax:
Practice Address - Street 1:325 HILLCREST BLVD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-4382
Practice Address - Country:US
Practice Address - Phone:734-808-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty