Provider Demographics
NPI:1821724204
Name:COLLINS, KIT BRYAN (LMHCA)
Entity Type:Individual
Prefix:
First Name:KIT
Middle Name:BRYAN
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:BRYAN
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2414 42ND AVE E APT 216
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-2523
Mailing Address - Country:US
Mailing Address - Phone:703-850-4490
Mailing Address - Fax:
Practice Address - Street 1:2100 WESTLAKE AVE N STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5802
Practice Address - Country:US
Practice Address - Phone:206-657-6083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61327915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health