Provider Demographics
NPI:1720682818
Name:COLLINS, TERENCE DREW I (MA, LGPC)
Entity Type:Individual
Prefix:MR
First Name:TERENCE
Middle Name:DREW
Last Name:COLLINS
Suffix:I
Gender:M
Credentials:MA, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 EAST GRV
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2447
Mailing Address - Country:US
Mailing Address - Phone:240-271-7448
Mailing Address - Fax:
Practice Address - Street 1:6801 WALKER MILL RD
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-4503
Practice Address - Country:US
Practice Address - Phone:240-271-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10530101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional