Judith Glass Collins, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00003707 Issued in WA

Practice address

20174 Front St NE
Poulsbo, WA 98370-7445

Phone

(360) 697-1141

Fax

(360) 697-2395

NPI assigned

Oct 17, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Front Street Clinic Inc

  • Psychologist
  • Poulsbo, WA
  • NPI 1457532913
  NPD (past)
• Wandee J. Pryor, Psy.D., LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Poulsbo, WA
  • NPI 1376043232
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1114179462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEADE RD",
            "city": "NORDLAND",
            "state": "WA",
            "postal_code": "983589618",
            "telephone_number": "360-379-9448",
            "fax_number": "360-379-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20174 FRONT ST NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707445",
            "telephone_number": "360-697-1141",
            "fax_number": "360-697-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JUDITH",
        "middle_name": "GLASS",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Nathanial Clark, D.C.
• Jonna Clark, MS, OTR/L
• Alicia McKenna Cole, P.T.
• Jeremy Rossa Cole, LCSW
• Ann Michelle Collins
• Lacey M Collins, LMP
• Margaret Colson, NP
• Alexander Nathaniel Combs-Bachmann, DO
• Cherese Combs, DNP
• Come Alive Youth Services, LLC

• Clinical Psychologist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.