Healthcare Provider Details

I. General information

NPI: 1851226294
Provider Name (Legal Business Name): COURTNEY HOLLOWAY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VETERANS AVE
BILOXI MS
39531-2410
US

IV. Provider business mailing address

8356 BLUETT TANNER RD
WILMER AL
36587-3327
US

V. Phone/Fax

Practice location:
  • Phone: 251-281-6423
  • Fax:
Mailing address:
  • Phone: 251-281-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6293B
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: