Provider Demographics
NPI:1720210081
Name:COLLINS, KATHLEEN ELIZABETH (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ELIZABETH
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3649 CEDARVIEW CT
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2877
Mailing Address - Country:US
Mailing Address - Phone:563-332-4361
Mailing Address - Fax:
Practice Address - Street 1:3649 CEDARVIEW CT
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-2877
Practice Address - Country:US
Practice Address - Phone:563-332-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00425101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health