Mary Collins, LPC-IT, CSAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7634-125 Issued in WI

Practice address

20 S Main St Ste 21
Janesville, WI 53545-3959

Phone

(608) 851-0348

Fax

(815) 737-8115

NPI assigned

Apr 23, 2015

Last updated

May 14, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Willows Counseling and Emdr Center

  • Professional Counselor
  • Janesville, WI
  • NPI 1043830334
  NPD Authorized official
• Trivium LLC

  dba Crossroads Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Janesville, WI
  • NPI 1265450753
  NPD (past)
• Trivium LLC

  dba Crossroads Counseling Center

  • Adolescent and Children Mental Health Clinic/Center
  • Sun Prairie, WI
  • NPI 1427463066
  NPD (past)

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1811384241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20759 BURR OAK RD",
            "city": "CAPRON",
            "state": "IL",
            "postal_code": "610129616",
            "telephone_number": "815-482-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S MAIN ST STE 21",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453959",
            "telephone_number": "608-851-0348",
            "fax_number": "815-737-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MARY",
        "credential": "LPC-IT, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16284-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3943-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7634-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100078408",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Keith Clausen, DPT
• Clover Family Services LLC
• Tania Mischelle Cobena Bravo, MD
• Jeanne E Cole, R.N.
• Karyn Jean Coleman, PT
• Bailee Noel Combs, MMT, MT-BC, NMT
• Community Action Inc of Rock & Walworth County (First Choice Womens Health Center)
• Stacy M. Condon, LCSW
• Krystal A Conkle, MSW, LCSW
• Amy M Connell, MD

• Professional Counselor in Janesville, WI
• Providers in Janesville, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.