Provider Demographics
NPI:1437867470
Name:MCCOLLUM, L'OREAL PORCEIA (LCSW, MSW, MED)
Entity type:Individual
Prefix:MS
First Name:L'OREAL
Middle Name:PORCEIA
Last Name:MCCOLLUM
Suffix:
Gender:F
Credentials:LCSW, MSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 N 2ND ST # 1104
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-3033
Mailing Address - Country:US
Mailing Address - Phone:267-585-6319
Mailing Address - Fax:
Practice Address - Street 1:201 S 18TH ST APT 1114
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5943
Practice Address - Country:US
Practice Address - Phone:267-585-6319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0259041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical