Provider Demographics
NPI:1639060726
Name:COLLISION COUNSELING PLLC
Entity type:Organization
Organization Name:COLLISION COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-791-6470
Mailing Address - Street 1:12345 LAKE CITY WAY NE # 2266
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5401
Mailing Address - Country:US
Mailing Address - Phone:425-217-3197
Mailing Address - Fax:425-740-1391
Practice Address - Street 1:1710 144 PL SW
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087
Practice Address - Country:US
Practice Address - Phone:425-217-3197
Practice Address - Fax:425-740-1391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty