Provider Demographics
NPI:1962492280
Name:COLLINS, JULIE ANNE (LMHC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:DELEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5201 E US HIGHWAY 36
Mailing Address - Street 2:SUITE 503
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7837
Mailing Address - Country:US
Mailing Address - Phone:317-745-9555
Mailing Address - Fax:317-745-9565
Practice Address - Street 1:540 TRACY RD
Practice Address - Street 2:SUITE C
Practice Address - City:NEW WHITELAND
Practice Address - State:IN
Practice Address - Zip Code:46184-9699
Practice Address - Country:US
Practice Address - Phone:765-482-7421
Practice Address - Fax:765-482-7462
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000263A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000363881OtherANTHEM BCBS