Provider Demographics
NPI:1659054062
Name:COLLINS, KALA (LPC-A)
Entity Type:Individual
Prefix:
First Name:KALA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 THOMSON CIR
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-5658
Mailing Address - Country:US
Mailing Address - Phone:864-378-8987
Mailing Address - Fax:
Practice Address - Street 1:936 MARKET ST STE 206
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6564
Practice Address - Country:US
Practice Address - Phone:704-502-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional