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General NPI Number Information
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NPI Number | 1174290274
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Entity Type | Individual
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Provider Name | HEIDI LYN COLLINS MH24634 , CAP100128
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Gender | Female
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 400 MAITLAND AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-5419
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Country | US
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Telephone | 407-831-2991
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Fax |
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Provider Business Mailing Address
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Address Line | 1297 EAGLE RIDGE DR
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City | THE VILLAGES
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State | FL
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Zip | 32162-7732
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Country | US
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Telephone | 561-307-5567
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH24634
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License Number State | FL
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