Healthcare Provider Details

I. General information

NPI: 1720396559
Provider Name (Legal Business Name): PATRICIA ALICE COLLINS RDN, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PARK AVE STE 304
FALLS CHURCH VA
22046-4309
US

IV. Provider business mailing address

200 PARK AVE STE 304
FALLS CHURCH VA
22046-4309
US

V. Phone/Fax

Practice location:
  • Phone: 703-388-6291
  • Fax:
Mailing address:
  • Phone: 703-388-6291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC4486
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX3278
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number260678
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPRC14452
License Number StateDC
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701005962
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLC4486
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number000982
License Number StateCT
# 9
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number887998
License Number StateMD
# 10
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLC4486
License Number State
# 11
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC4486
License Number StateMD
# 12
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberNU134
License Number StateDC
# 13
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number002478
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: