Healthcare Provider Details

I. General information

NPI: 1922595149
Provider Name (Legal Business Name): HEIDI COLLIER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 E BRANDON BLVD # 1292
BRANDON FL
33511-5509
US

IV. Provider business mailing address

1032 E BRANDON BLVD # 1292
BRANDON FL
33511-5509
US

V. Phone/Fax

Practice location:
  • Phone: 334-456-8809
  • Fax:
Mailing address:
  • Phone: 334-456-8809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4639C
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW24499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: