Provider Demographics
NPI:1508482621
Name:ANA COLLAZO, LSCSW, LLC
Entity Type:Organization
Organization Name:ANA COLLAZO, LSCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-925-9088
Mailing Address - Street 1:5601 SW 34TH TER
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-4557
Mailing Address - Country:US
Mailing Address - Phone:785-608-3184
Mailing Address - Fax:785-271-9003
Practice Address - Street 1:225 SW 12TH ST STE 203
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66612-1310
Practice Address - Country:US
Practice Address - Phone:785-235-6500
Practice Address - Fax:785-271-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1851733844OtherNPPES