Healthcare Provider Details

I. General information

NPI: 1376131342
Provider Name (Legal Business Name): HEATHER HOLLINSWORTH MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 06/13/2023
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17304 PRESTON RD # 831A
DALLAS TX
75252-5618
US

IV. Provider business mailing address

321 BENJAMIN ST
DENTON TX
76207-7604
US

V. Phone/Fax

Practice location:
  • Phone: 405-458-9408
  • Fax:
Mailing address:
  • Phone: 214-454-1475
  • Fax: 214-856-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number81894
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: