Provider Demographics
NPI:1265724223
Name:COLLINGSWORTH, MARJORI (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:MARJORI
Middle Name:
Last Name:COLLINGSWORTH
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8305 PACIFIC PEARL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-2591
Mailing Address - Country:US
Mailing Address - Phone:214-991-5720
Mailing Address - Fax:
Practice Address - Street 1:8305 PACIFIC PEARL DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-2591
Practice Address - Country:US
Practice Address - Phone:214-991-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional