Provider Demographics
NPI:1912785213
Name:COLLINS, MARIE (LPC, LMFT, LAC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC, LMFT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 W PINHOOK RD STE 100A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3745
Mailing Address - Country:US
Mailing Address - Phone:337-981-2180
Mailing Address - Fax:
Practice Address - Street 1:102 ABACO LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8153
Practice Address - Country:US
Practice Address - Phone:337-501-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1027106H00000X
LA1013101YA0400X
LA3149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)