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NPI Code Detail

MEDICARE: BRYAN B COLLINS III LCSW

MEDICARE:   BRYAN B COLLINS III LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW-897GA

General Provider Information

NPI Number : 1164774543
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN B COLLINS III LCSW
Provider Business Mailing Address
First Line : 236 E LAKE DR APT 4
Second Line :
City : DECATUR
State : GA
Zip : 30030-3513
Country : US
Telephone Number : 877-299-9944
Fax Number :
Provider Business Practice Location Address
First Line : 236 E LAKE DR APT 4
Second Line :
City : DECATUR
State : GA
Zip : 30030-3513
Country : US
Telephone Number : 877-299-9944
Fax Number : 307-939-2830
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2012
Last Update Date : 02/27/2026

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Directions to “ BRYAN B COLLINS III LCSW” Practice Location

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