Provider Demographics
NPI:1609275379
Name:MELISSA S. COLLINS
Entity Type:Organization
Organization Name:MELISSA S. COLLINS
Other - Org Name:MELISSA S. COLLINS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LAC
Authorized Official - Phone:406-531-7164
Mailing Address - Street 1:302 N 1ST ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2556
Mailing Address - Country:US
Mailing Address - Phone:406-531-7164
Mailing Address - Fax:
Practice Address - Street 1:302 N 1ST ST
Practice Address - Street 2:4A
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2599
Practice Address - Country:US
Practice Address - Phone:406-531-7164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1169101YA0400X
MT9831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty