Provider Demographics
NPI:1356157366
Name:COLLIER, SHELLEY CHRISTINE SISSON (LPC)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:CHRISTINE SISSON
Last Name:COLLIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:CHRISTINE
Other - Last Name:SISSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2480 WINDY HILL RD SE STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8656
Mailing Address - Country:US
Mailing Address - Phone:678-892-7713
Mailing Address - Fax:
Practice Address - Street 1:2480 WINDY HILL RD SE STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8656
Practice Address - Country:US
Practice Address - Phone:678-892-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015179101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health