Provider Demographics
NPI:1952664203
Name:COLLINS SERVICES & MANAGEMENT LLC
Entity Type:Organization
Organization Name:COLLINS SERVICES & MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:469-337-7152
Mailing Address - Street 1:PO BOX 263
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75120-0263
Mailing Address - Country:US
Mailing Address - Phone:469-337-7152
Mailing Address - Fax:972-875-3808
Practice Address - Street 1:107 S GAINES ST STE 105
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4612
Practice Address - Country:US
Practice Address - Phone:469-337-7152
Practice Address - Fax:972-875-3808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty