Provider Demographics
NPI:1609149301
Name:COLLINS, JOAN LOUISE (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:LOUISE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 MARSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1817
Mailing Address - Country:US
Mailing Address - Phone:415-262-0232
Mailing Address - Fax:415-683-3207
Practice Address - Street 1:333 HAYES ST
Practice Address - Street 2:210
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4453
Practice Address - Country:US
Practice Address - Phone:415-585-5046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical