Provider Demographics
NPI:1851759518
Name:COLLINS, ERICA QUINN (LAC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:QUINN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-1735
Mailing Address - Country:US
Mailing Address - Phone:973-625-7150
Mailing Address - Fax:973-625-7107
Practice Address - Street 1:50 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1735
Practice Address - Country:US
Practice Address - Phone:973-625-7150
Practice Address - Fax:973-625-7107
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00252700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health