Healthcare Provider Details

I. General information

NPI: 1063240877
Provider Name (Legal Business Name): HOLLY S MCCLOY MA, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 MORLATT LN
MARTINSBURG WV
25404-7613
US

IV. Provider business mailing address

232 MORLATT LN
MARTINSBURG WV
25404-7613
US

V. Phone/Fax

Practice location:
  • Phone: 304-261-4774
  • Fax:
Mailing address:
  • Phone: 304-261-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1141
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: