Healthcare Provider Details

I. General information

NPI: 1689595142
Provider Name (Legal Business Name): HOLLIS CALVIN HENRY M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CALVIN HENRY M.S.

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE BLDG 4
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

542 ARGONNE DR NW
ATLANTA GA
30305-2839
US

V. Phone/Fax

Practice location:
  • Phone: 678-336-6875
  • Fax:
Mailing address:
  • Phone: 404-386-8066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: