Active NPI
Stacy Nichols Collins, M.S., NCC, LPC
- Professional Counselor
- Lawrenceville, GA
National Provider Identifier
1760719736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC004513
- Practice address
- 190 Camden Hill Rd
Suite a
Lawrenceville, GA 30046-2448 - Phone
- (770) 513-8988
- Fax
- (770) 513-2565
- NPI assigned
- Nov 11, 2009
- Last updated
- Nov 11, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC004513 | GA | |
| Professional Counselor | 101YP2500X | LPC004513 | GA | Primary |
Addresses
Primary practice location
190 Camden Hill Rd
Suite a
Lawrenceville, GA 30046-2448
Mailing address
190 Camden Hill Rd
Suite a
Lawrenceville, GA 30046-2448
Phone (770) 513-8988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC004513 | GA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanta Family Counseling Center, Inc | Mental Health | Past | Accepting new patients |
| Flourish Family Therapy | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Addiction (Substance Use Disorder) Counselor
- Lawrenceville, GA
- NPI 1487734372
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257897600000",
"number": "1760719736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 CAMDEN HILL RD",
"address_2": "SUITE A",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300462448",
"telephone_number": "770-513-8988",
"fax_number": "770-513-2565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 CAMDEN HILL RD",
"address_2": "SUITE A",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300462448",
"telephone_number": "770-513-8988",
"fax_number": "770-513-2565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "STACY",
"middle_name": "NICHOLS",
"credential": "M.S., NCC, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-11",
"last_updated": "2009-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC004513",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC004513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.