Healthcare Provider Details

I. General information

NPI: 1104037720
Provider Name (Legal Business Name): WILLIAM MARK HOLLAND PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 DELL DR
RALEIGH NC
27609-7119
US

IV. Provider business mailing address

3405 DELL DR
RALEIGH NC
27609-7119
US

V. Phone/Fax

Practice location:
  • Phone: 919-971-3064
  • Fax:
Mailing address:
  • Phone: 919-971-3064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number4429
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4429
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: