Provider Demographics
NPI:1700496056
Name:COLLINS, CARRIE F
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:F
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 HOME WOOD CT
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1681
Mailing Address - Country:US
Mailing Address - Phone:513-379-4672
Mailing Address - Fax:
Practice Address - Street 1:7000 HOUSTON RD STE 16
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4882
Practice Address - Country:US
Practice Address - Phone:513-379-4672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health