Provider Demographics
NPI:1972090629
Name:COLLINS, NONA A (LADAC)
Entity type:Individual
Prefix:MS
First Name:NONA
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LADAC
Other - Prefix:
Other - First Name:NONA
Other - Middle Name:A
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSAA,CCSS
Mailing Address - Street 1:2444 PLAZA VIZCAYA NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-2936
Mailing Address - Country:US
Mailing Address - Phone:505-318-5750
Mailing Address - Fax:
Practice Address - Street 1:610 GOLD AVE SW STE 102
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3187
Practice Address - Country:US
Practice Address - Phone:505-318-5750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCAD0224801101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty