MEDICARE: ANDRIA HOLLINGSHEAD LMHP, LADC, CPC, NCC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	1181	NE
2	101YM0800X	Mental Health Counselor	4842	NE
3	101YP2500X	Professional Counselor	2316	NE

General Provider Information

NPI Number	:	1770032526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRIA HOLLINGSHEAD LMHP, LADC, CPC, NCC

Provider Business Mailing Address
First Line	:	511 W SIERRA WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6034
Country	:	US
Telephone Number	:	402-515-5059
Fax Number	:	509-381-3536

Provider Business Practice Location Address
First Line	:	8619 N DIVISION ST STE B
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-5944
Country	:	US
Telephone Number	:	140-251-5505
Fax Number	:	509-381-3536

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

Provider Enumeration Date	:	09/21/2016
Last Update Date	:	02/05/2024

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