Healthcare Provider Details

I. General information

NPI: 1013694876
Provider Name (Legal Business Name): HOLLY A EICHNER PHD, CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 W SOUTH BOUNDARY ST
PERRYSBURG OH
43551-5238
US

IV. Provider business mailing address

3420 CORAL AVE
TOLEDO OH
43623-1910
US

V. Phone/Fax

Practice location:
  • Phone: 419-931-3022
  • Fax:
Mailing address:
  • Phone: 567-249-5219
  • 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: