Provider Demographics
NPI:1558748673
Name:COLLINS, ROSALYN (MH, CAP)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MH, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 W ATLANTIC AVE STE C17
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3706
Mailing Address - Country:US
Mailing Address - Phone:561-381-0015
Mailing Address - Fax:561-423-0104
Practice Address - Street 1:4733 W ATLANTIC AVE STE C17
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3706
Practice Address - Country:US
Practice Address - Phone:561-381-0015
Practice Address - Fax:561-423-0104
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2124101YA0400X
FL5941101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)