Provider Demographics
NPI:1508030115
Name:COLLINS, PHYLLIS GAIL (MS, LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:GAIL
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-0034
Mailing Address - Country:US
Mailing Address - Phone:713-817-7035
Mailing Address - Fax:281-491-3565
Practice Address - Street 1:4800 SUGAR GROVE BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2635
Practice Address - Country:US
Practice Address - Phone:713-817-7035
Practice Address - Fax:281-491-3565
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61025101YP2500X
TX200936106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist