Provider Demographics
NPI:1023456068
Name:COLLIER, SHANNON MARIE (LCSW-S)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIE
Last Name:COLLIER
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 ANTOINE DR STE B-136
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-3357
Mailing Address - Country:US
Mailing Address - Phone:785-580-8402
Mailing Address - Fax:
Practice Address - Street 1:5018 ANTOINE DR STE B-136
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092
Practice Address - Country:US
Practice Address - Phone:785-580-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker