Active NPI
Courtney Alexzandra Collins
- Addiction (Substance Use Disorder) Counselor
- Portsmouth, OH
National Provider Identifier
1942856109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.172884
- Practice address
- 411 Court St
Portsmouth, OH 45662-3932 - Phone
- (740) 354-6685
- NPI assigned
- Aug 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | QMHS | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.172884 | OH | Primary |
Addresses
Primary practice location
411 Court St
Portsmouth, OH 45662-3932
Mailing address
214 Havens LN
Waverly, OH 45690-9051
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.172884 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| QMHS | OH | MD | Mental Health Clinic/Center (Including Community Mental Health Center) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1942856109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 HAVENS LN",
"city": "WAVERLY",
"state": "OH",
"postal_code": "456909051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 COURT ST",
"city": "PORTSMOUTH",
"state": "OH",
"postal_code": "456623932",
"telephone_number": "740-354-6685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "COURTNEY",
"middle_name": "ALEXZANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-14",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "QMHS",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.172884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.