Provider Demographics
NPI:1407443104
Name:COLLINS, VIRGINIA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:OK
Mailing Address - Zip Code:73077-5022
Mailing Address - Country:US
Mailing Address - Phone:918-308-5512
Mailing Address - Fax:580-215-5767
Practice Address - Street 1:502 N 14TH ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OK
Practice Address - Zip Code:73077-5022
Practice Address - Country:US
Practice Address - Phone:580-749-5057
Practice Address - Fax:918-308-5512
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker