Individual provider Active NPI

Christine B Collins, LCSW

  • Clinical Social Worker
  • Sarasota, FL
National Provider Identifier
1740351840
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW454 Issued in FL
Practice address
3392 Magic Oak LN
Sarasota, FL 34232-1822
Phone
(941) 378-0003
NPI assigned
Nov 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW454 FL Primary

Addresses

Primary practice location

3392 Magic Oak LN
Sarasota, FL 34232-1822

Mailing address

3392 Magic Oak LN
Sarasota, FL 34232-1822
Phone (941) 378-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220421001416 ME Practitioner - Clinical Social Worker 5496847089 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW454FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life by Design, PA Clinical CurrentSince Mar 29, 2022 Accepting new patients
Carlos G. Otis Health Care Center Inc. PastSince Mar 29, 2022 Accepting new patients
Charis Center Clinical PastSince Apr 7, 2014 Accepting new patients
Life by Design Past Accepting new patients

Locations

18 High St
Houlton, ME 04730
Phone (207) 532-9660

147 Academy St
Presque Isle, ME 04769
Phone (207) 532-9660

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247788800000",
    "number": "1740351840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3392 MAGIC OAK LN",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342321822",
            "telephone_number": "941-378-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3392 MAGIC OAK LN",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342321822",
            "telephone_number": "941-378-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CHRISTINE",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2009-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.