Provider Demographics
NPI:1386338234
Name:COLLINS, HALEY MELISSA (LPC)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:MELISSA
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 1:6024 FAIR WINDS CV
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-0057
Mailing Address - Country:US
Mailing Address - Phone:770-967-8714
Mailing Address - Fax:
Practice Address - Street 1:6024 FAIR WINDS CV
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-0057
Practice Address - Country:US
Practice Address - Phone:770-967-8714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012014101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional