Healthcare Provider Details

I. General information

NPI: 1871752121
Provider Name (Legal Business Name): RICHARD C COLLINS LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RICK C COLLINS LMFT

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-1841 FORT WEAVER RD
EWA BEACH HI
96706-1909
US

IV. Provider business mailing address

91-1841 FORT WEAVER RD
EWA BEACH HI
96706-1909
US

V. Phone/Fax

Practice location:
  • Phone: 808-681-3500
  • Fax: 808-681-1486
Mailing address:
  • Phone: 808-681-3500
  • Fax: 808-681-1486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT - 190
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: