Provider Demographics
NPI:1871234153
Name:COLLINS, CHRISTIN JO (MS, LMHCA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIN
Middle Name:JO
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5074 PARTERRA CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-2269
Mailing Address - Country:US
Mailing Address - Phone:317-728-5021
Mailing Address - Fax:
Practice Address - Street 1:5074 PARTERRA CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-2269
Practice Address - Country:US
Practice Address - Phone:317-527-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99101859A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health