Provider Demographics
NPI:1972227932
Name:COLLINS, JENNIFER L (CADC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-3533
Mailing Address - Country:US
Mailing Address - Phone:201-736-2328
Mailing Address - Fax:
Practice Address - Street 1:338 FOREST ST
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3533
Practice Address - Country:US
Practice Address - Phone:201-736-2328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)