Provider Demographics
NPI:1598807612
Name:COLLIER, LUCY J (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:J
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 PERALTA AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2401
Mailing Address - Country:US
Mailing Address - Phone:510-665-4874
Mailing Address - Fax:
Practice Address - Street 1:1940B VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-2136
Practice Address - Country:US
Practice Address - Phone:510-665-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37260106H00000X
TX201480106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist