Healthcare Provider Details

I. General information

NPI: 1639268998
Provider Name (Legal Business Name): COLLINS CONSULTING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S TOWNSEND ST
ADA OK
74820-6429
US

IV. Provider business mailing address

18363 COUNTY ROAD 1560
ADA OK
74820-1319
US

V. Phone/Fax

Practice location:
  • Phone: 580-436-9341
  • Fax:
Mailing address:
  • Phone: 580-332-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1021
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. REBECCA ADAIR COLLINS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 580-332-7878