Provider Demographics
NPI:1437362803
Name:COLLETT, TERESA A (LPC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:COLLETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:AR
Mailing Address - Zip Code:72855-4225
Mailing Address - Country:US
Mailing Address - Phone:870-631-1553
Mailing Address - Fax:
Practice Address - Street 1:2711 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:AR
Practice Address - Zip Code:72855-4225
Practice Address - Country:US
Practice Address - Phone:870-631-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1303024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health