Provider Demographics
NPI:1083930457
Name:COLLINS, COURTENAY B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:COURTENAY
Middle Name:B
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:COURTENAY
Other - Middle Name:B
Other - Last Name:BLACKWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 NE 48TH AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-1102
Mailing Address - Country:US
Mailing Address - Phone:352-438-9563
Mailing Address - Fax:
Practice Address - Street 1:652 SILVER PASS
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-2229
Practice Address - Country:US
Practice Address - Phone:352-804-4994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-10
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLSW223831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical