Provider Demographics
NPI:1972711638
Name:COLLIER, LAURA J (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:COLLIER
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 1:2022 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1608
Mailing Address - Country:US
Mailing Address - Phone:706-649-6500
Mailing Address - Fax:706-649-6521
Practice Address - Street 1:2022 15TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1608
Practice Address - Country:US
Practice Address - Phone:706-649-6500
Practice Address - Fax:706-649-6521
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional