Provider Demographics
NPI:1285190181
Name:COLLINS-KING, JENNY SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:SUE
Last Name:COLLINS-KING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 1ST NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4605
Mailing Address - Country:US
Mailing Address - Phone:423-616-0213
Mailing Address - Fax:865-381-0521
Practice Address - Street 1:300 W 1ST NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4605
Practice Address - Country:US
Practice Address - Phone:423-616-0213
Practice Address - Fax:865-381-0521
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000022786251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNLSW0000004983OtherN/A