Provider Demographics
NPI:1245064542
Name:COLLINS, JAMIL (MSW)
Entity type:Individual
Prefix:
First Name:JAMIL
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4143 DAY BRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-7236
Mailing Address - Country:US
Mailing Address - Phone:941-465-3630
Mailing Address - Fax:
Practice Address - Street 1:4143 DAY BRIDGE PL
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-7236
Practice Address - Country:US
Practice Address - Phone:941-465-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical