Healthcare Provider Details

I. General information

NPI: 1306788633
Provider Name (Legal Business Name): HOLLY KATHRYN MANN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 TOWN PLAZA CT STE D
WINTER SPRINGS FL
32708-6231
US

IV. Provider business mailing address

2031 BRISSON AVE
SANFORD FL
32771-8464
US

V. Phone/Fax

Practice location:
  • Phone: 618-559-0750
  • Fax:
Mailing address:
  • Phone: 618-559-0750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27460
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: