Healthcare Provider Details

I. General information

NPI: 1235301227
Provider Name (Legal Business Name): TERESA RAPER COLLINS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERRY R. COLLINS LPC

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 ALTON CT
LOWELL NC
28098-2205
US

IV. Provider business mailing address

PO BOX 813
LOWELL NC
28098-0813
US

V. Phone/Fax

Practice location:
  • Phone: 704-824-2441
  • Fax:
Mailing address:
  • Phone: 704-855-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number510
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: