Provider Demographics
NPI:1235301227
Name:COLLINS, TERESA RAPER (LPC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:RAPER
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:R
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 813
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28098-0813
Mailing Address - Country:US
Mailing Address - Phone:704-855-4411
Mailing Address - Fax:
Practice Address - Street 1:2012 ALTON CT
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:NC
Practice Address - Zip Code:28098-2205
Practice Address - Country:US
Practice Address - Phone:704-824-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC510101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional