Provider Demographics
NPI:1770909137
Name:COLLINS, ALICIA (LPC)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10920 AIRLINE HWY
Mailing Address - Street 2:#52
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4297
Mailing Address - Country:US
Mailing Address - Phone:225-636-9416
Mailing Address - Fax:
Practice Address - Street 1:606 COLONIAL DR
Practice Address - Street 2:SUITE D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6535
Practice Address - Country:US
Practice Address - Phone:225-239-5498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional