1629256540 NPI number — RACHEL W COLLINS MS,BA,LPC

Table of content: RACHEL W COLLINS MS,BA,LPC (NPI 1629256540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629256540 NPI number — RACHEL W COLLINS MS,BA,LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLLINS
Provider First Name:
RACHEL
Provider Middle Name:
W
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS,BA,LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629256540
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
428 COLUMBUS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06519-1233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-503-3059
Provider Business Mailing Address Fax Number:
203-503-3066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
428 COLUMBUS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06519-1233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-503-3059
Provider Business Practice Location Address Fax Number:
203-503-3066
Provider Enumeration Date:
02/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  002524 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12696221 . This is a "CAQH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "MULTIPLAN AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "OPTUM BEHAVIORAL HEALTH OXFORD FREEDOM/LIBERTY AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "ANTHEM BCBS OF CT AWAKEN THE POWER THERAPY, LLC" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "OPTUM BEHAVIORAL HEALTH- UNITED HEALTHCARE AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "FEI BEHAVIORAL HEALTH AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "OPTUM BEHAVIORAL HEALTH-CONNECTICARE AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "BEACON HEALTH STRATEGIES-VO AWAKEN THE POWER THERAPY, LLC" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "OPTUM BEHAVIORAL HEALTH AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008050783 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4903859 PENDING . This is a "CIGNA BEHAVIORAL HEALTH AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 472092928 . This is a "THREE RIVERS AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: PENDING . This is a "HEALTHYCT AWAKEN THE POWER THERAPY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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