Healthcare Provider Details

I. General information

NPI: 1578024394
Provider Name (Legal Business Name): HOLLIE H ARAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3941 68TH AVE N
PINELLAS PARK FL
33781-6136
US

IV. Provider business mailing address

4501 W WATROUS AVE
TAMPA FL
33629-4231
US

V. Phone/Fax

Practice location:
  • Phone: 404-227-3149
  • Fax:
Mailing address:
  • Phone: 404-227-3149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: