Provider Demographics
NPI:1871674945
Name:COLLINS, CARLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:LEHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10333E 21ST N
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206
Mailing Address - Country:US
Mailing Address - Phone:316-630-8444
Mailing Address - Fax:
Practice Address - Street 1:10333 E 21ST ST N
Practice Address - Street 2:ADVOCATES FOR BEHAVIORAL HALTH
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206
Practice Address - Country:US
Practice Address - Phone:316-630-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1336103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral