Provider Demographics
NPI:1912629312
Name:CAREY, COLLIN M (LLPC)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:M
Last Name:CAREY
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 GABRIELLE CT NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-6409
Mailing Address - Country:US
Mailing Address - Phone:616-914-8186
Mailing Address - Fax:
Practice Address - Street 1:2215 29TH ST SE STE B8A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-1565
Practice Address - Country:US
Practice Address - Phone:616-404-7004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022410101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor