Provider Demographics
NPI:1225400179
Name:COLLIER, SATIRA (MA LLPC LBSW)
Entity Type:Individual
Prefix:MS
First Name:SATIRA
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MA LLPC LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15088 MESA WAY BLDG 35
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-3283
Mailing Address - Country:US
Mailing Address - Phone:734-620-3634
Mailing Address - Fax:313-758-0255
Practice Address - Street 1:2995 E GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3133
Practice Address - Country:US
Practice Address - Phone:313-758-0158
Practice Address - Fax:313-758-0255
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009838101YP2500X
MI6802084238104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker