Healthcare Provider Details

I. General information

NPI: 1245157502
Provider Name (Legal Business Name): LAWRENCE T HOLLOWAY JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FRANKLIN ST
HAMPTON VA
23669-3568
US

IV. Provider business mailing address

1 FRANKLIN ST
HAMPTON VA
23669-3568
US

V. Phone/Fax

Practice location:
  • Phone: 757-727-2000
  • Fax:
Mailing address:
  • Phone: 757-727-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701014282
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: