Provider Demographics
NPI:1447432224
Name:COLLINS, DANA LEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LEE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80866-0711
Mailing Address - Country:US
Mailing Address - Phone:719-687-1353
Mailing Address - Fax:719-687-1353
Practice Address - Street 1:627 W MIDLAND AVE
Practice Address - Street 2:203
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-1284
Practice Address - Country:US
Practice Address - Phone:719-687-1353
Practice Address - Fax:719-687-1353
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional