Individual provider Active NPI

Evan Maclean Collins, LAC

  • Counselor
  • Trenton, NJ
National Provider Identifier
1386499648
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
37AC00735400 Issued in NJ
Practice address
3535 Quakerbridge Rd Ste 300
Trenton, NJ 08619-1200
Phone
(609) 415-1757
NPI assigned
Apr 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 37AC00735400 NJ Primary

Addresses

Primary practice location

3535 Quakerbridge Rd Ste 300
Trenton, NJ 08619-1200

Mailing address

105 Ketterer CT
Lawrence Township, NJ 08648-2855
Phone (609) 651-9303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37AC00735400NJMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1713571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1386499648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KETTERER CT",
            "city": "LAWRENCE TOWNSHIP",
            "state": "NJ",
            "postal_code": "086482855",
            "telephone_number": "609-651-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 QUAKERBRIDGE RD STE 300",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086191200",
            "telephone_number": "609-415-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "EVAN",
        "middle_name": "MACLEAN",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-20",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37AC00735400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2024; 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.