Provider Demographics
NPI:1992374425
Name:COLLINS, NAESHAUN D (LMSW)
Entity Type:Individual
Prefix:
First Name:NAESHAUN
Middle Name:D
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 MARY TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-4473
Mailing Address - Country:US
Mailing Address - Phone:205-913-8195
Mailing Address - Fax:
Practice Address - Street 1:2959 MARY TAYLOR RD
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-4473
Practice Address - Country:US
Practice Address - Phone:205-913-8195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5481G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty