MEDICARE: MR. JOHN DAVID COLLINS LCSW-C, C-ASWCM, MSW

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	1041C0700X	Clinical Social Worker	11312	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972699734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN DAVID COLLINS LCSW-C, C-ASWCM, MSW

Provider Business Mailing Address
First Line	:	540 RIVERSIDE DR
Second Line	:	SUITE 8
City	:	SALISBURY
State	:	MD
Zip	:	21801-5352
Country	:	US
Telephone Number	:	410-548-3333
Fax Number	:	410-548-3341

Provider Business Practice Location Address
First Line	:	540 RIVERSIDE DR
Second Line	:	SUITE 8
City	:	SALISBURY
State	:	MD
Zip	:	21801-5352
Country	:	US
Telephone Number	:	410-548-3333
Fax Number	:	410-548-3341

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	09/02/2010

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Directions to “ MR. JOHN DAVID COLLINS LCSW-C, C-ASWCM, MSW” Practice Location

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