Healthcare Provider Details

I. General information

NPI: 1073565032
Provider Name (Legal Business Name): LINDA JOAN COLLINGS PH.D., M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SAINT ANN DR STE 2
MANDEVILLE LA
70471-3394
US

IV. Provider business mailing address

215 SAINT ANN DR STE 2
MANDEVILLE LA
70471-3394
US

V. Phone/Fax

Practice location:
  • Phone: 985-951-2250
  • Fax: 985-951-2253
Mailing address:
  • Phone: 985-951-2250
  • Fax: 985-951-2253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberMP.000020
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: