Provider Demographics
NPI:1497115430
Name:COLLINS, JARRED CYREUS (LPC)
Entity Type:Individual
Prefix:MR
First Name:JARRED
Middle Name:CYREUS
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 DIVISION ST
Mailing Address - Street 2:#2
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-4673
Mailing Address - Country:US
Mailing Address - Phone:337-967-1083
Mailing Address - Fax:
Practice Address - Street 1:215 BRES AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5860
Practice Address - Country:US
Practice Address - Phone:318-509-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional