Provider Demographics
NPI:1992685713
Name:COLLINS, CAYDEN (LMBT)
Entity type:Individual
Prefix:
First Name:CAYDEN
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 PINEVILLE MATTHEWS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-6174
Mailing Address - Country:US
Mailing Address - Phone:704-541-8655
Mailing Address - Fax:
Practice Address - Street 1:7215 PINEVILLE MATTHEWS RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-6174
Practice Address - Country:US
Practice Address - Phone:704-541-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22221225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist