Provider Demographics
NPI:1730243601
Name:COLLINS, ANN MARIE (PHD, APRN,BC, LPC)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHD, APRN,BC, LPC
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:COLTART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14011 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1319
Mailing Address - Country:US
Mailing Address - Phone:248-541-8591
Mailing Address - Fax:
Practice Address - Street 1:30400 TELEGRAPH RD
Practice Address - Street 2:SUTIE 324
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4537
Practice Address - Country:US
Practice Address - Phone:248-540-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008012101YM0800X
MI4704085418364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent