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General NPI Number Information
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NPI Number | 1154039808
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Entity Type | Individual
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Provider Name | VERNISHA SOPHIA HOLLAND LPC
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Gender | Female
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 3630 GEORGE WASHINGTON MEM HWY STE F1
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City | YORKTOWN
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State | VA
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Zip | 23693-3350
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Country | US
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Telephone | 757-204-1866
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Fax | 757-782-4004
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Provider Business Mailing Address
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Address Line | 200 SAINT CLAIR CIR APT C
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City | YORKTOWN
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State | VA
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Zip | 23693-4166
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Country | US
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Telephone | 757-289-4850
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701013023
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License Number State | VA
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