Provider Demographics
NPI:1720190150
Name:COLLINS CENTER
Entity Type:Organization
Organization Name:COLLINS CENTER
Other - Org Name:CITIZENS AGAINST SEXUAL ASSAULT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-432-6430
Mailing Address - Street 1:217 S LIBERTY ST APT 205
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3676
Mailing Address - Country:US
Mailing Address - Phone:540-432-6430
Mailing Address - Fax:
Practice Address - Street 1:217 S LIBERTY ST, SUITE 205
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-432-6430
Practice Address - Fax:540-432-6293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003977101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty