Provider Demographics
NPI:1891989554
Name:KOLLAR, AMY KATHERN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHERN
Last Name:KOLLAR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:KATHERN
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:608 BOSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4029
Mailing Address - Country:US
Mailing Address - Phone:410-493-8072
Mailing Address - Fax:
Practice Address - Street 1:608 BOSLEY AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4029
Practice Address - Country:US
Practice Address - Phone:410-493-8072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2076101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional