Provider Demographics
NPI:1689093619
Name:COLLINS, JOSEPH (LPCC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 143RD ST W STE 300
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5529
Mailing Address - Country:US
Mailing Address - Phone:262-902-5757
Mailing Address - Fax:
Practice Address - Street 1:7600 143RD ST W STE 300
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5529
Practice Address - Country:US
Practice Address - Phone:651-373-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional