Healthcare Provider Details

I. General information

NPI: 1861316796
Provider Name (Legal Business Name): JAMES PATRICK COLLARD MS, CGC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE STREET DANCEBLUE CLINIC, C423
LEXINGTON KY
40536
US

IV. Provider business mailing address

800 ROSE STREET DANCEBLUE CLINIC, C423
LEXINGTON KY
40536
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-3442
  • Fax: 859-257-8978
Mailing address:
  • Phone: 859-218-3442
  • Fax: 859-257-8978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberTGC097
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: