Healthcare Provider Details

I. General information

NPI: 1922960640
Provider Name (Legal Business Name): HOLLY GUELIG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 LAKESIDE AVE
HENRICO VA
23228-5248
US

IV. Provider business mailing address

6200 LAKESIDE AVE
HENRICO VA
23228-5248
US

V. Phone/Fax

Practice location:
  • Phone: 804-293-0761
  • Fax:
Mailing address:
  • Phone: 804-307-2801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015659
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: