Provider Demographics
NPI:1669523007
Name:COLLINS, DAWN A (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 PARKDALE PL
Mailing Address - Street 2:SUITE 209
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-6601
Mailing Address - Country:US
Mailing Address - Phone:317-362-8951
Mailing Address - Fax:317-280-1704
Practice Address - Street 1:6820 PARKDALE PL
Practice Address - Street 2:SUITE 209
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-6601
Practice Address - Country:US
Practice Address - Phone:317-362-8951
Practice Address - Fax:317-280-1704
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001579A106H00000X
CT000243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist