Provider Demographics
NPI:1033954201
Name:COLLIER, JAYCIE E (LAC)
Entity type:Individual
Prefix:
First Name:JAYCIE
Middle Name:E
Last Name:COLLIER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8217
Mailing Address - Country:US
Mailing Address - Phone:870-777-9051
Mailing Address - Fax:870-777-3104
Practice Address - Street 1:300 E 20TH ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-8217
Practice Address - Country:US
Practice Address - Phone:870-777-9051
Practice Address - Fax:870-777-3104
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2406012101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor