Montique S Collins

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

6439857 Issued in AZ

Practice address

729 W Maldonado Rd
Phoenix, AZ 85041-6763

Phone

(602) 455-4626

Fax

(602) 455-2624

NPI assigned

Jan 4, 2018

Last updated

Mar 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1811404437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 W GLENDALE AVE",
            "address_2": "16",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85051",
            "telephone_number": "602-455-4626",
            "fax_number": "602-455-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 W MALDONADO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416763",
            "telephone_number": "602-455-4626",
            "fax_number": "602-455-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MONTIQUE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "6439857",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "AZ",
            "license": "6439857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindell Y Collins, MD
• Lindsey Collins
• Melanie Collins, R.N.
• Merrillyn Ann Collins, LCSW
• Michael Collins, MD
• Nicole Danielle Collins
• Roseanne Kelton Collins, M.D.
• Shivi Collins
• Tyler Collins, MD
• Tricha Collinson, RN

• Foster Care Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Foster Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.