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General NPI Number Information
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NPI Number | 1780483529
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Entity Type | Individual
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Provider Name | JAMES D COLLINS LAC,LCADC, CCS
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Gender | Male
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 28 CHARTER OAK ST
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-2204
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Country | US
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Telephone | 201-279-2194
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Fax | 201-279-2194
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Provider Business Mailing Address
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Address Line | 28 CHARTER OAK ST
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-2204
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Country | US
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Telephone | 201-279-2194
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Fax | 201-279-2194
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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 | 37AC00429400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00303000
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License Number State | NJ
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