Provider Demographics
NPI:1346482494
Name:COLLINS-REED, JENNA MICHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:MICHELLE
Last Name:COLLINS-REED
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 1:6805 IL 162
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062
Mailing Address - Country:US
Mailing Address - Phone:618-288-5019
Mailing Address - Fax:618-288-5059
Practice Address - Street 1:7 GLEN ED PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-3333
Practice Address - Country:US
Practice Address - Phone:618-806-4205
Practice Address - Fax:618-288-7398
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490128191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical