Provider Demographics
NPI:1174017735
Name:COLLINS, ANNE-MARIE (MS, LMHC, ATR)
Entity type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, LMHC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-5326
Mailing Address - Country:US
Mailing Address - Phone:850-490-1961
Mailing Address - Fax:
Practice Address - Street 1:913 GULF BREEZE PKWY STE 26A
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4731
Practice Address - Country:US
Practice Address - Phone:850-972-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11-250221700000X
FLMH19238101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH19238OtherTHE FLORIDA BOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY AND MENTAL