Provider Demographics
NPI:1588404651
Name:COLLINS, ALLYSON MICHELLE (MS, LPC)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:MICHELLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 HARDINGS MILL RD
Mailing Address - Street 2:
Mailing Address - City:NATHALIE
Mailing Address - State:VA
Mailing Address - Zip Code:24577-3044
Mailing Address - Country:US
Mailing Address - Phone:434-222-1332
Mailing Address - Fax:
Practice Address - Street 1:143 INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23927-3140
Practice Address - Country:US
Practice Address - Phone:434-572-6916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health