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General NPI Number Information
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NPI Number | 1427341528
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Entity Type | Individual
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Provider Name | PORSCHE RENNA COLLINS LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 769 N WENDOVER RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1118
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Country | US
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Telephone | 704-376-7180
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Fax | 704-531-9266
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Provider Business Mailing Address
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Address Line | 12868 CLYDESDALE DR
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City | MIDLAND
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State | NC
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Zip | 28107-7825
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Country | US
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Telephone | 203-430-7551
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C007571
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007089
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34009362A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11817
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW005802
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License Number State | GA
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