1811514615 NPI number — COLLINS PSYCHOTHERAPY, PLLC

Table of content: (NPI 1811514615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811514615 NPI number — COLLINS PSYCHOTHERAPY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLLINS PSYCHOTHERAPY, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1811514615
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12001 INWOOD RD APT 1502
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75244-4004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-726-6095
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12001 INWOOD RD APT 1502
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75244-4004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-726-6095
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2020

Additional Information

Authorized Official

Authorized Official Last Name:
COLLINS
Authorized Official First Name:
WILL
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
214-726-6094

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 36756 . This is a "LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0093ZE , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0093ZE . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 37807 . This is a "LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8KE519 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00Q84X . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8KE519 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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