Provider Demographics
NPI:1962006353
Name:COLLINS, JOSEPH (LMFT 138560)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LMFT 138560
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT 138560
Mailing Address - Street 1:6442 PLATT AVE # 448
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3216
Mailing Address - Country:US
Mailing Address - Phone:818-208-1777
Mailing Address - Fax:888-388-0796
Practice Address - Street 1:1554 SINALOA RD # 26
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3032
Practice Address - Country:US
Practice Address - Phone:818-208-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138560106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist