Provider Demographics
NPI:1629844162
Name:COLLIER PROFESSIONAL COUNSELING, LLC
Entity Type:Organization
Organization Name:COLLIER PROFESSIONAL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:208-972-4691
Mailing Address - Street 1:2308 N COLE RD STE C
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-7361
Mailing Address - Country:US
Mailing Address - Phone:208-972-4691
Mailing Address - Fax:208-576-6110
Practice Address - Street 1:2308 N COLE RD STE C
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7361
Practice Address - Country:US
Practice Address - Phone:208-972-4691
Practice Address - Fax:208-576-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)