Provider Demographics
NPI:1962917369
Name:COLLINS, CHINELL Z (LPC)
Entity type:Individual
Prefix:
First Name:CHINELL
Middle Name:Z
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 1:7200 JOHNSON FARM LN APT 407
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9066
Mailing Address - Country:US
Mailing Address - Phone:267-968-5935
Mailing Address - Fax:
Practice Address - Street 1:7200 JOHNSON FARM LN APT 407
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9066
Practice Address - Country:US
Practice Address - Phone:267-968-5935
Practice Address - Fax:267-968-5935
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010052101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional