Provider Demographics
NPI:1164893509
Name:COLLINS, ELIZABETH R (MS, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:R
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:R
Other - Last Name:BARCLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 EAST ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1234
Mailing Address - Country:US
Mailing Address - Phone:413-529-7242
Mailing Address - Fax:413-527-2138
Practice Address - Street 1:203 EAST ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1234
Practice Address - Country:US
Practice Address - Phone:413-529-7242
Practice Address - Fax:413-527-2138
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12228101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health