Provider Demographics
NPI:1730693094
Name:COLLINS, NATASHIA (LPC, ATR-BC, ACS,)
Entity type:Individual
Prefix:
First Name:NATASHIA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC, ATR-BC, ACS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5165
Mailing Address - Country:US
Mailing Address - Phone:973-433-5644
Mailing Address - Fax:
Practice Address - Street 1:307 BLOOMFIELD AVE STE 301
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5165
Practice Address - Country:US
Practice Address - Phone:973-433-5644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-24
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
221700000X
NJ37PC00549000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist