Provider Demographics
NPI:1831493873
Name:COLLISON, NATALIE GENE (MA LMHC)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:GENE
Last Name:COLLISON
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 CONTENTA RDG
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-6604
Mailing Address - Country:US
Mailing Address - Phone:505-438-6571
Mailing Address - Fax:
Practice Address - Street 1:4710 CONTENTA RDG
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-6604
Practice Address - Country:US
Practice Address - Phone:505-438-6571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0136101101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor