Provider Demographics
NPI:1477751865
Name:COLLINS, VIRGINIA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1237 CANDLEWOOD COURT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-7000
Mailing Address - Country:US
Mailing Address - Phone:630-615-8991
Mailing Address - Fax:630-801-5616
Practice Address - Street 1:1237 CANDLEWOOD CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-7000
Practice Address - Country:US
Practice Address - Phone:630-615-8991
Practice Address - Fax:630-801-5616
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0031611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL581092000OtherMAGELLAN USER NAME