Provider Demographics
NPI:1689732323
Name:COLLIER, MARY KATHLEEN (LCMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHLEEN
Last Name:COLLIER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-6122
Mailing Address - Country:US
Mailing Address - Phone:828-695-5900
Mailing Address - Fax:828-695-4256
Practice Address - Street 1:350 E PARKER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5155
Practice Address - Country:US
Practice Address - Phone:828-624-1900
Practice Address - Fax:828-438-6225
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5389101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1689732323OtherMEDCOST
NC6103451Medicaid
NC600464-032OtherMAGELLAN
NC147PHOtherBCBS
NC1689732323OtherTRICARE/HEALTH NET FEDERAL SVS