Courtney Dwayne Collier, CADC, NCC, MBA, CPRS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1600 Issued in TN

Practice address

200 Martin Luther King Jr. Dr.
#7730
Jackson, TN 38302

Phone

(731) 300-1104

NPI assigned

Dec 27, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1114433281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING JR. DR.",
            "address_2": "#7730",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38302",
            "telephone_number": "731-300-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING JR. DR.",
            "address_2": "#7730",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38302",
            "telephone_number": "731-300-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "COURTNEY",
        "middle_name": "DWAYNE",
        "name_prefix": "Mr.",
        "credential": "CADC, NCC, MBA, CPRS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-27",
        "last_updated": "2024-09-03",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "TN-068",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "7385",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "TN",
            "license": "000-1142",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Deniece Coleman, MD
• Jennifer Coleman, FNP
• Joseph Curtis Coleman, MD
• Ashton Coles, FNP-BC
• Lismar Collado, MD
• Stephen Edward Collier, M.D.
• Cassandra Ine Faye Collins
• Desiree Coman
• Lacynthia Quarnetta Comer, MSW
• Community Impact Collective

• Addiction (Substance Use Disorder) Counselor in Jackson, TN
• Providers in Jackson, TN by specialty
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.