Provider Demographics
NPI:1588551212
Name:COLLIER, JERRALL
Entity type:Individual
Prefix:
First Name:JERRALL
Middle Name:
Last Name:COLLIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 WARRENSVILLE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1929
Mailing Address - Country:US
Mailing Address - Phone:216-502-6667
Mailing Address - Fax:
Practice Address - Street 1:5112 WARRENSVILLE CENTER RD
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1929
Practice Address - Country:US
Practice Address - Phone:216-502-6667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor