Provider Demographics
NPI:1982256848
Name:COLLINS, COURTNEY (LPCC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 W CHURCH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-5050
Mailing Address - Country:US
Mailing Address - Phone:740-934-6474
Mailing Address - Fax:740-934-6473
Practice Address - Street 1:68 W CHURCH ST STE 203
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-5050
Practice Address - Country:US
Practice Address - Phone:740-934-6474
Practice Address - Fax:740-934-6473
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1901806101Y00000X
OHE.2303402101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor