Healthcare Provider Details

I. General information

NPI: 1598052003
Provider Name (Legal Business Name): RACHEL HOLLADAY-COFFMAN LPC CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5321 JOHN F KENNEDY BLVD
NORTH LITTLE ROCK AR
72116-6777
US

IV. Provider business mailing address

3508 JOHN F KENNEDY BLVD STE 2
NORTH LITTLE ROCK AR
72116-8843
US

V. Phone/Fax

Practice location:
  • Phone: 501-992-7527
  • Fax:
Mailing address:
  • Phone: 501-992-7527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA1503046
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1809115
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: