Healthcare Provider Details

I. General information

NPI: 1831455492
Provider Name (Legal Business Name): HOLLY JASMINE MORIN LCMHC, LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10239 BEACH DR SW STE 12
CALABASH NC
28467-2703
US

IV. Provider business mailing address

10239 BEACH DR SW STE 12
CALABASH NC
28467-2703
US

V. Phone/Fax

Practice location:
  • Phone: 910-477-0881
  • Fax: 910-946-6213
Mailing address:
  • Phone: 910-477-0881
  • Fax: 910-946-6213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC4430
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5561
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22752
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: