Provider Demographics
NPI:1033678446
Name:COLLIER, CHARITY CARLA (CADCII)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:CARLA
Last Name:COLLIER
Suffix:
Gender:F
Credentials:CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 1/2 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-3427
Mailing Address - Country:US
Mailing Address - Phone:978-407-0330
Mailing Address - Fax:
Practice Address - Street 1:145B SOUTHERN BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-7416
Practice Address - Country:US
Practice Address - Phone:978-407-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1289101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)