Individual provider Active NPI

Mark Collins, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1861704769
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
36594 Issued in TX
Practice address
8204 Elmbrook Dr
Suite 305-B
Dallas, TX 75247-4067
Phone
(214) 687-8365
NPI assigned
Jul 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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 36594 TX Primary

Addresses

Primary practice location

8204 Elmbrook Dr
Suite 305-B
Dallas, TX 75247-4067

Mailing address

8204 Elmbrook Dr
Suite 305-B
Dallas, TX 75247-4067
Phone (214) 687-8365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36594TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1861704769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8204 ELMBROOK DR",
            "address_2": "SUITE 305-B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474067",
            "telephone_number": "214-687-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8204 ELMBROOK DR",
            "address_2": "SUITE 305-B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474067",
            "telephone_number": "214-687-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "36594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.