Organization
THE OPEN TABLE CINCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ROBERT COLLINS LPCC, LICDC (FOUNDER)
(513) 900-7619
Entity
Organization
Contact information
Practice address
1213 TENNESSEE AVE STE 204, CINCINNATI, OH 45229-1044
(513) 900-7619
Mailing address
5432 NORTHCREST LN APT 3, CINCINNATI, OH 45247-6415
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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