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General NPI Number Information
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NPI Number | 1629583620
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Entity Type | Individual
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Provider Name | HOLLEY MICHELLE ELAM LPC
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Gender | Female
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 5634 E 78TH PL
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City | TULSA
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State | OK
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Zip | 74136-8413
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Country | US
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Telephone | 432-254-9450
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Fax | 832-626-3028
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Provider Business Mailing Address
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Address Line | 5634 E 78TH PL
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City | TULSA
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State | OK
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Zip | 74136-8413
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Country | US
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Telephone | 432-254-9450
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Fax | 832-626-3028
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 73702
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License Number State | TX
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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 | 0782
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License Number State | OK
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