Healthcare Provider Details

I. General information

NPI: 1912317652
Provider Name (Legal Business Name): ELIZABETH COLLINS L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2014
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 GOVERNOR ST SUITE 202
PROVIDENCE RI
02906
US

IV. Provider business mailing address

189 GOVERNOR ST SUITE 202
PROVIDENCE RI
02906
US

V. Phone/Fax

Practice location:
  • Phone: 401-519-5190
  • Fax: 401-495-0404
Mailing address:
  • Phone: 401-519-5190
  • Fax: 401-495-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberDAOM00053
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberDA00430
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberDACM00053
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: