Provider Demographics
NPI:1013700715
Name:COLLOT, EVENS LUTHER
Entity type:Individual
Prefix:MR
First Name:EVENS
Middle Name:LUTHER
Last Name:COLLOT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BOX TURTLE LN
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5681
Mailing Address - Country:US
Mailing Address - Phone:856-418-6721
Mailing Address - Fax:856-818-9740
Practice Address - Street 1:531 WILLIAMSTOWN RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1869
Practice Address - Country:US
Practice Address - Phone:856-418-6721
Practice Address - Fax:856-818-9740
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty