MEDICARE: DEAVON LYNETTE COLLINS LPC-IT

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
1	101YM0800X	Mental Health Counselor	4259	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4259	OTHER	WI	LPC-IT

General Provider Information

NPI Number	:	1588125546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEAVON LYNETTE COLLINS LPC-IT

Provider Business Mailing Address
First Line	:	4906 W FOND DU LAC AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2325
Country	:	US
Telephone Number	:	414-270-4670
Fax Number	:

Provider Business Practice Location Address
First Line	:	4906 W FOND DU LAC AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2325
Country	:	US
Telephone Number	:	414-270-4670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2019
Last Update Date	:	03/30/2019

Similar Medicare Providers

1093153199 — ADELINE HOOKER CSAC
Practice Location Address:

4906 W FOND DU LAC AVE
MILWAUKEE, WI
53216-2325

Practice Phone: 414-449-4777
Practice Fax: 414-270-2971

1851249627 — CHRISTINE WIESE LPC-IT
Practice Location Address:

4906 W FOND DU LAC AVE
MILWAUKEE, WI
53216-2325

Practice Phone: 414-449-4777
Practice Fax: 414-270-2971

1952608721 — COMMUNITY ADVOCATES, INC
Practice Location Address:

4906 W FOND DU LAC AVE
MILWAUKEE, WI
53216-2325

Practice Phone: 414-449-4777
Practice Fax: 414-270-2971

1164823852 — LINDA LATRICIA COBBS LPC-IT, SAC
Practice Location Address:

4906 W FOND DU LAC AVE
MILWAUKEE, WI
53216-2325

Practice Phone: 414-270-4629
Practice Fax: 414-312-6116

1659714558 — BLAKE DIALYSIS LLC
Practice Location Address:

4176 N 56TH ST
MILWAUKEE, WI
53216-1276

Practice Phone: 414-445-2119
Practice Fax: 414-445-3794

1467312397 — A GRANDMOTHER'S TOUCH
Practice Location Address:

4429 W HOWIE PL
MILWAUKEE, WI
53216-2426

Practice Phone: 414-607-2314
Practice Fax:

Directions to “ DEAVON LYNETTE COLLINS LPC-IT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.