Provider Demographics
NPI:1568420727
Name:COLLINS, VALARIE (MA, LPCC)
Entity Type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:VALARIE
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,LPCC
Mailing Address - Street 1:3935 PERKINS MADDEN RD
Mailing Address - Street 2:
Mailing Address - City:AMBURGEY
Mailing Address - State:KY
Mailing Address - Zip Code:41773-8741
Mailing Address - Country:US
Mailing Address - Phone:606-875-5931
Mailing Address - Fax:
Practice Address - Street 1:3935 PERKINS MADDEN RD
Practice Address - Street 2:
Practice Address - City:AMBURGEY
Practice Address - State:KY
Practice Address - Zip Code:41773-8741
Practice Address - Country:US
Practice Address - Phone:606-875-5931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0968101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY184607OtherGROUP MEDICARE #