Provider Demographics
NPI:1730318551
Name:COLLINS, ABBEY SWAN
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:SWAN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBEY
Other - Middle Name:L
Other - Last Name:SWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1437 S BELCHER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-2829
Mailing Address - Country:US
Mailing Address - Phone:727-524-4464
Mailing Address - Fax:727-524-4474
Practice Address - Street 1:1437 S BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-2829
Practice Address - Country:US
Practice Address - Phone:727-524-4464
Practice Address - Fax:727-524-4474
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 13758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health