Provider Demographics
NPI:1457085441
Name:COLLIS, DANIA DEBBIE ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DANIA
Middle Name:DEBBIE ANN
Last Name:COLLIS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DANIA
Other - Middle Name:DEBBIE-ANN
Other - Last Name:EBANKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4007 JUSTIN WAY
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1476
Mailing Address - Country:US
Mailing Address - Phone:478-216-7378
Mailing Address - Fax:
Practice Address - Street 1:183 W CLINTON ST
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:GA
Practice Address - Zip Code:31032-5301
Practice Address - Country:US
Practice Address - Phone:478-216-7378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0081341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical