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General NPI Number Information
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NPI Number | 1386150902
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Entity Type | Individual
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Provider Name | MICHAEL HOLLAND LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 3471 OHIO RIVER ROAD
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City | POINT PLEASANT
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State | WV
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Zip | 25550
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Country | US
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Telephone | 304-812-5965
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Fax | 304-812-5961
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Provider Business Mailing Address
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Address Line | PO BOX 457
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City | BEAVER
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State | PA
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Zip | 15009-0457
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Country | US
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Telephone | 724-660-4159
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Fax | 724-660-4233
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | CP00943198
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License Number State | WV
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