Active NPI
Carla Sue Collins
- Developmental Therapist
- Harrisburg, IL
National Provider Identifier
1477074078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 22 Veterans Drive
P.O. Box 869
Harrisburg, IL 62946-6294 - Phone
- (618) 252-0377
- Fax
- (618) 252-2389
- NPI assigned
- Jul 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
22 Veterans Drive
P.O. Box 869
Harrisburg, IL 62946-6294
Mailing address
511 S Graham Ave Apt 310
Carbondale, IL 62901-3377
Phone (618) 262-6283
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coleman Tri-County Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Developmentally Disabled Services Day Training Agency
- Harrisburg, IL
- NPI 1336272764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1477074078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 S GRAHAM AVE APT 310",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013377",
"telephone_number": "618-262-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 VETERANS DRIVE",
"address_2": "P.O. BOX 869",
"city": "HARRISBURG",
"state": "IL",
"postal_code": "629466294",
"telephone_number": "618-252-0377",
"fax_number": "618-252-2389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "CARLA",
"middle_name": "SUE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-05",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.