Provider Demographics
NPI:1801405121
Name:COLLINGTON, EBONI (LPC)
Entity Type:Individual
Prefix:
First Name:EBONI
Middle Name:
Last Name:COLLINGTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9727 COUNTRY MEADOWS LN APT 3A
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-6304
Mailing Address - Country:US
Mailing Address - Phone:551-697-5790
Mailing Address - Fax:
Practice Address - Street 1:650 I ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4350
Practice Address - Country:US
Practice Address - Phone:240-324-6524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional