MEDICARE: SHAWANDA HOLLOWAY LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH20882	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285074203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWANDA HOLLOWAY LMHC

Provider Business Mailing Address
First Line	:	7101 WILSON BLVD APT 1204
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-3687
Country	:	US
Telephone Number	:	904-765-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 PRUDENTIAL DR STE 512
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8207
Country	:	US
Telephone Number	:	904-376-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	12/12/2025

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Directions to “ SHAWANDA HOLLOWAY LMHC” Practice Location

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