Individual
MARY NICOLE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
BEHAVIORAL HEALTH CENTER CMC RANDOLPH, 501 BILLINGSLEY ROAD, CHARLOTTE, NC 28211-1009
(704) 358-2700
(704) 358-2716
Mailing address
BEHAVIORAL HEALTH CENTER CMC RANDOLPH, 501 BILLINGSLEY ROAD, CHARLOTTE, NC 28211-1009
(704) 358-2710
(704) 358-2938
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102759
—
NC
Enumeration date
07/10/2006
Last updated
07/08/2007
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