Kenneth Collins
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Blythe, CA
NPI 1366812414 · NPPES record last updated Jan 26, 2024
Key facts
- NPI
- 1366812414
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 9826 18TH Ave
Blythe, CA 92225-9229 - Phone
- (760) 922-8625
- NPI assigned
- Oct 1, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Veterans Alcohol Rehabilitation Program, Inc.-Varp, Inc. | Current |
Accepting new patients | |
| Veterans Alcohol Rehabilitation Program, Inc.- Varp, Inc. | Past |
Accepting new patients |
Locations
9826 18th Ave
Blythe, CA 92225
Phone (760) 550-4684
1100 N D St
San Bernardino, CA 92410
Phone (909) 884-0840
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
9826 18TH Ave
Blythe, CA 92225-9229
Mailing address
1100 N D St
San Bernardino, CA 92410-3524
Phone (760) 922-8625
Other providers in Blythe, CA
- Erica Danielle Clark
- Clear Vision Treatment Centers Inc.
- Clinicas de Salud del Pueblo, Inc
- Aurora Angela Colangeli
- Stephen R Colestock Jr.
- Angela Diane Copple
- Corrections and Rehabilitation-Headquarters
- Damian Cortez
- County of Riverside
- County of Riverside
All providers in Blythe, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.