Provider Demographics
NPI:1316734411
Name:COLLINS, MOLLY JOANNA (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:JOANNA
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:MISS
Other - First Name:MOLLY
Other - Middle Name:JOANNA
Other - Last Name:HARGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17408 NE 105TH ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-8001
Mailing Address - Country:US
Mailing Address - Phone:913-837-0705
Mailing Address - Fax:
Practice Address - Street 1:9 VICTORY DR STE 1A
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3807
Practice Address - Country:US
Practice Address - Phone:913-837-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019029467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional