MEDICARE: CONNIE S COLLINS LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	33013450A	IN

General Provider Information

NPI Number	:	1578495065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE S COLLINS LSW

Provider Business Mailing Address
First Line	:	2177 INTELLIPLEX DR STE 221
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8584
Country	:	US
Telephone Number	:	317-207-1830
Fax Number	:

Provider Business Practice Location Address
First Line	:	2177 INTELLIPLEX DR STE 221
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8584
Country	:	US
Telephone Number	:	317-207-1830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ CONNIE S COLLINS LSW” Practice Location

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