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General NPI Number Information
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NPI Number | 1902386345
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Entity Type | Individual
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Provider Name | CORYN COLLINS LMFT, LPC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 1105 DEER ST STE 9
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City | CONWAY
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State | AR
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Zip | 72032-5450
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Country | US
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Telephone | 501-505-4020
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Fax | 505-859-0060
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Provider Business Mailing Address
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Address Line | 1105 DEER ST STE 9
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City | CONWAY
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State | AR
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Zip | 72032-5450
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Country | US
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Telephone | 501-505-4020
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Fax | 505-859-0060
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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 | A1805047
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M2101022
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License Number State | AR
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