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General NPI Number Information
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NPI Number | 1346770542
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Entity Type | Individual
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Provider Name | HOLLY ANN HEMMINGER LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 224 W D. L. INGRAM AVE BLDG. 1408
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City | CANON AIR FORCE BASE
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State | NM
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Zip | 87103
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Country | US
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Telephone | 575-637-4131
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 W YUCCA AVE
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City | CLOVIS
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State | NM
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Zip | 88101-3335
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Country | US
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Telephone | 575-520-1660
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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 | 101YM0800X
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Taxonomy Name | Mental Health 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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-11012
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License Number State | NM
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