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General NPI Number Information
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NPI Number | 1215819602
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Entity Type | Individual
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Provider Name | MATASHIA MASHAY COLLIER LPC, LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1441 WOODMONT LN NW # 123
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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Country | US
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Telephone | 762-465-9438
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Fax |
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Provider Business Mailing Address
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Address Line | 3013 OLD HATLEY RD
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City | CORDELE
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State | GA
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Zip | 31015-8268
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Country | US
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Telephone | 229-938-8569
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC009631
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW009841
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License Number State | GA
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