Provider Demographics
NPI:1013004001
Name:COLLINS, WINSTON (DSW)
Entity Type:Individual
Prefix:DR
First Name:WINSTON
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1758 HOLLINS RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4613
Mailing Address - Country:US
Mailing Address - Phone:215-638-7363
Mailing Address - Fax:215-638-7363
Practice Address - Street 1:444 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-4107
Practice Address - Country:US
Practice Address - Phone:215-487-6374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-001551-L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker