Provider Demographics
NPI:1609825900
Name:COLLINGE, WILLIAM BATEMAN (MSW, PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BATEMAN
Last Name:COLLINGE
Suffix:
Gender:M
Credentials:MSW, PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3480 KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4312
Mailing Address - Country:US
Mailing Address - Phone:541-632-3502
Mailing Address - Fax:207-510-8060
Practice Address - Street 1:3480 KINCAID ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4312
Practice Address - Country:US
Practice Address - Phone:541-632-3502
Practice Address - Fax:207-510-8060
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC83151041C0700X
ORL52521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM9089Medicare ID - Type Unspecified