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General NPI Number Information
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NPI Number | 1477888741
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Entity Type | Individual
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Provider Name | MICHAEL WILLIAM HOLLAND PH.D., LPC, LADAC
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Gender | Male
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 65 E. SUNBRIDGE DR.
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2894
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Country | US
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Telephone | 479-443-9707
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Fax | 479-443-4505
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Provider Business Mailing Address
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Address Line | 65 E. SUNBRIDGE DR. 65 E. SUNBRIDGE DR.
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2894
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Country | US
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Telephone | 479-443-9707
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Fax | 479-443-4505
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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 | 0264L
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License Number State | AR
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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 | P0710061
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License Number State | AR
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