Provider Demographics
NPI:1932210390
Name:COLLINS, DENISE (LPCC, LICDC, CEAP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPCC, LICDC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11475 GREY FRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-8350
Mailing Address - Country:US
Mailing Address - Phone:440-285-8442
Mailing Address - Fax:440-285-8443
Practice Address - Street 1:20690 LAKELAND BLVD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-3241
Practice Address - Country:US
Practice Address - Phone:216-404-1900
Practice Address - Fax:216-404-1901
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0000904101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional