Healthcare Provider Details
I. General information
NPI: 1487581724
Provider Name (Legal Business Name): HOLLEY'S HELPING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3309 W CULLOM AVE APT 1
CHICAGO IL
60618-2273
US
IV. Provider business mailing address
3309 W CULLOM AVE APT 1
CHICAGO IL
60618-2273
US
V. Phone/Fax
- Phone: 316-304-5527
- Fax:
- Phone: 316-304-5527
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
HOLLEY
RENA
BLOOMFIELD
Title or Position: CLINICAL THERAPIST
Credential: LCPC
Phone: 316-304-5527