Provider Demographics
NPI:1295365567
Name:COLLINS, LORETTA (LGPC)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:LORETTA
Other - Middle Name:C
Other - Last Name:BEGG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LGPC
Mailing Address - Street 1:7474 GREENWAY CENTER DR STE 730
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3523
Mailing Address - Country:US
Mailing Address - Phone:301-345-1022
Mailing Address - Fax:301-560-5558
Practice Address - Street 1:16220 FREDERICK RD STE 319
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4039
Practice Address - Country:US
Practice Address - Phone:301-345-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10096101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional