Provider Demographics
NPI:1952549206
Name:COLLINS, CLAUDIA NICHELLE (LCAS)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:NICHELLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4311 OFFSHORE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-2684
Mailing Address - Country:US
Mailing Address - Phone:919-625-8930
Mailing Address - Fax:919-758-8848
Practice Address - Street 1:4311 OFFSHORE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-2684
Practice Address - Country:US
Practice Address - Phone:919-625-8930
Practice Address - Fax:919-758-8848
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-24
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1217101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)