Provider Demographics
NPI:1811388911
Name:COLLMAN-MURPHY, JACE REID (LCAS, CCS)
Entity type:Individual
Prefix:MR
First Name:JACE
Middle Name:REID
Last Name:COLLMAN-MURPHY
Suffix:
Gender:M
Credentials:LCAS, CCS
Other - Prefix:
Other - First Name:JACE
Other - Middle Name:REID
Other - Last Name:COLLMAN-MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCAS CCS
Mailing Address - Street 1:2640 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-6120
Mailing Address - Country:US
Mailing Address - Phone:828-919-2171
Mailing Address - Fax:
Practice Address - Street 1:2640 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-6120
Practice Address - Country:US
Practice Address - Phone:828-919-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-3523101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty