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Organization

PSYCHIATRIC PROFESSIONAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES COLLINS MD (AUTHORIZED OFFICIAL)
(513) 558-4898
Entity
Organization

Contact information

Practice address
234 GOODMAN ST., CINCINNATI, OH 45219-2364
(513) 584-8577
(513) 584-5501
Mailing address
2830 VICTORY PARKWAY, CINCINNATI, OH 45206-1785
(513) 245-3637
(513) 245-3637

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
163WP0808X
Psychiatric/Mental Health Registered Nurse
2084P0800X
Psychiatry Physician
Primary
261QM0850X
Adult Mental Health Clinic/Center
363L00000X
Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0621036
OH
05
65917338
KY
Enumeration date
10/02/2006
Last updated
06/16/2010
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