Healthcare Provider Details

I. General information

NPI: 1467053405
Provider Name (Legal Business Name): KALYN COLLINS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7117 TULANE AVE
UNIVERSITY CITY MO
63130-2343
US

IV. Provider business mailing address

3824 S GRAND BLVD
SAINT LOUIS MO
63118-3412
US

V. Phone/Fax

Practice location:
  • Phone: 402-706-8881
  • Fax:
Mailing address:
  • Phone: 314-814-8180
  • Fax: 314-814-8188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2023034006
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: