Provider Demographics
NPI:1003143710
Name:COLLING, JENNIFER LANTZ (LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LANTZ
Last Name:COLLING
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JEFFIFER
Other - Middle Name:
Other - Last Name:LANTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1509 N. MILITARY TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:561-223-2986
Mailing Address - Fax:888-221-7996
Practice Address - Street 1:1509 N. MILITARY TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-223-2986
Practice Address - Fax:888-221-7996
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ04ZROtherFLORIDA BLUE