Provider Demographics
NPI:1114200888
Name:COLLINS, MELISSA M (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:M
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-S
Mailing Address - Street 1:6060 N CENTRAL EXPY STE 240
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5203
Mailing Address - Country:US
Mailing Address - Phone:214-883-7073
Mailing Address - Fax:
Practice Address - Street 1:6060 N. CENTRAL EXPRESSWAY,
Practice Address - Street 2:SUITE #463
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206
Practice Address - Country:US
Practice Address - Phone:214-883-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63513101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional