Provider Demographics
NPI:1699576264
Name:COLLINS CREEK COUNSELING
Entity type:Organization
Organization Name:COLLINS CREEK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:KORTHALS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:843-606-0529
Mailing Address - Street 1:742 MINK AVE # 118
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-6300
Mailing Address - Country:US
Mailing Address - Phone:843-352-3092
Mailing Address - Fax:
Practice Address - Street 1:250 SOUTHERN BREEZES CIR
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-9390
Practice Address - Country:US
Practice Address - Phone:843-606-0529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty