Provider Demographics
NPI:1558355412
Name:COLVIN, MARGARET KINKEAD (LPCMH RPT IBECPT NCE)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:KINKEAD
Last Name:COLVIN
Suffix:
Gender:F
Credentials:LPCMH RPT IBECPT NCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MICHAEL CT
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-8605
Mailing Address - Country:US
Mailing Address - Phone:302-227-2084
Mailing Address - Fax:
Practice Address - Street 1:115 N WALNUT ST
Practice Address - Street 2:STE C
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1447
Practice Address - Country:US
Practice Address - Phone:302-424-1322
Practice Address - Fax:302-424-7772
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC0000112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health