Provider Demographics
NPI:1386193142
Name:COLLIER COUNSELING, LLC
Entity Type:Organization
Organization Name:COLLIER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-618-1040
Mailing Address - Street 1:2295 PARKLAKE DR NE
Mailing Address - Street 2:SUITE 570
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2844
Mailing Address - Country:US
Mailing Address - Phone:404-618-1040
Mailing Address - Fax:404-618-1040
Practice Address - Street 1:2295 PARKLAKE DR NE
Practice Address - Street 2:SUITE 570
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2844
Practice Address - Country:US
Practice Address - Phone:404-618-1040
Practice Address - Fax:404-618-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0049181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty