Malissa Yvette Collins, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010995 Issued in GA

Practice address

470 Furys Ferry Rd
Martinez, GA 30907-9506

Phone

(762) 994-6792

Fax

(706) 739-7221

NPI assigned

Sep 28, 2019

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: malissacollins@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  GA, Professional

  Medicare reassignment Care Compare group NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Professional

  NPD
• Marvin Behavioral Health Ma PC

  • Psychologist
  • Boston, MA
  • NPI 1740860428
  NPD (past)

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

{
    "created_epoch": "1569628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1265083489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079506",
            "telephone_number": "762-994-6792",
            "fax_number": "706-739-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079506",
            "telephone_number": "762-994-6792",
            "fax_number": "706-739-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MALISSA",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Betterhelp.com",
            "affiliation": "N",
            "address_1": "728 Spotswood Dr",
            "city": "Evans",
            "state": "GA",
            "country_code": "US",
            "postal_code": "308095493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Martinez, GA
• Providers in Martinez, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.